Journal articles on the topic 'Liberty National Life Insurance Company'

This study sought to investigate the influence of customer retention on profitability of insurance companies in Kenya using Liberty Life Assurance Company Ltd as a proxy. The Specific objectives of the study were to examine the effect of product quality assess the effect of quality customer service, and to establish the influence of firms service/product pricing on profitability. The theories of Assimilation, Contrast, and Assimilation-Contrast guided this current study. Descriptive and correlational design were used on a target population of 2, 653 customers who have held life policies since 2010 with Liberty Life Assurance Co. The sample of the study consisted of 347 respondents. A questionnaire was used to collect primary data from customers while a structured interview schedule was used to collect qualitative data from 10 managers. Validity of instruments was ensured by consulting experts from Business Administration Department, Africa Nazarene University. Reliability of instruments was achieved through test-retest method on randomly selected 39 customers, whereby Cronbachs Alpha of 0.849 was calculated from the obtained data. Qualitative data was analyzed through thematic analysis while correlation and regression analysis were used to analyze the relationship between customer retention strategies and profitability in Liberty Life Ltd, Kenya. The study findings showed that 40.4% changes in profitability at Liberty Life Assurance is attributed to the customer retention strategies investigated by the study (R2 =0.4042). Findings also showed that product quality (β=0.428) quality of services (β=1.188) and product pricing (β=0.601) all are significant predictors {F (1, 338) =88.495, P<0.05} of profitability at Liberty Life. It is concluded that product quality, quality of services, and product pricing are critical customer retention strategies for enhancing firm profitability. The study therefore recommends insurance should adopt corporate social responsibility practices as well as flexibility mode of premium payment to improve and stabilize their customer base. Further research should be done on the influence of expanded benefits in insurance product packages on customer retention and profitability.

Life insurance is a very important segment of the economy of most countries as demonstrated by the investments, premium revenue and numbers employed. Hence, it is paramount to determine accurately how well life insurance companies (LICs) perform and how viable they are for the benefit of both other industries and national economies.Three papers that investigate LIC efficiency directly analyze how efficiency affects LIC profits. One critical feature is that they show that the inefficiency of LICs can greatly affect their (financial) outcome and ultimately their survivorship. Thus, said research clearly indicates that life insurer efficiency is a crucial area to investigate and assess and that it could greatly enhance the ability to properly monitor and inspect the life insurers.This article co-ordinates information regarding life insurance efficiency studies to help researchers learn which approaches, methods and output/input proxies to use. While some papers do so for some of the aspects that are important and necessary for life insurance efficiency studies, this is the first to deal with said aspects together. More specifically, this paper especially considers and evaluates the different methods and output proxies used in life insurance efficiency studies, as they seem to be the elements where the most disagreement exists between researchers. In addition, this article is unique in examining how input (proxy) prices are used in life insurance efficiency studies.

This research aims to analyze the description of the financial condition of the DuPont analysis of national life insurance companies, and to analyze the impact of the financial condition of DuPont analysis on the performance of national life insurance companies. The data is taken from financial reports for 4 (four) years from 2016 - 2019, which have been published which are data before the Covid-19 pandemic, via the website of each company. The research method used is descriptive qualitative with a case study approach on 10 (ten) national life insurance companies that have assets of more than IDR 1 trillion. The research samples are Return on Equity (ROE), Return on Assets (ROA), Total Assets Turn Over (TATO), Net Profit Margin (NPM), and Debt Ratio (DR). Meanwhile, data analysis was carried out by: tabulating data, performing calculations and grouping DuPont analysis, interpreting to determine the level of company profitability, and drawing conclusions on the results achieved. The results of the study show that the financial condition of national life insurance companies using DuPont analysis is generally less effective and efficient. The company has not utilized its resources fully, effectively and efficiently in terms of achieving maximum sales results, and the company still uses a lot of debt for its investment. Keywords: Effectiveness, DuPont Analysis, and Profitability

This paper is devoted to the construction of a mathematical model of financial dynamics of life insurance company. The methods of calculating insurance amounts, payments, net premium reserve are studied, their generalization is carried out taking into account various types of insurer's expenses for ensuring the activities of the insurance company, the sensitivity of the financial dynamics of the insurance company depending on the input parameters of the model is analyzed. The results of the work are of great practical importance for modeling the work of the insurance company, because the National Bank of Ukraine implements mandatory monitoring of the solvency of the insurance company on the basis of the insurer's reporting data.

This study aims to (1) analyze the condition of the application of financial leverage and operational leverage of PT. Asuransi Jiwa XYZ; (2) analyze the impact of the condition of applying financial leverage and operational leverage on the company's financial risk. This research method uses a quantitative descriptive method with a case study approach at PT Asuransi Jiwa XYZ. The type of research data used is secondary data, namely quantitative data in the form of financial report data for 2018-2020 obtained from the company's website. Data analysis techniques are performed by calculating financial leverage ratios and operational leverage, then interpretation is carried out. Then an analysis of the impact of the condition of the company's leverage on its financial risk is carried out. The results achieved are that in general financial leverage and operational leverage indicate poor performance. Meanwhile, the impact of financial leverage and operational leverage on the company's financial risk also indicates poor performance, this is possibly due to the impact of the Covid-19 pandemic which has hit the country and even the whole world. However, data from the previous two years had shown indications of a significant decline in the company's financial performance.

This study aims to criticize the application of sharia principles at the operational level of sharia insurance companies which are conventional insurance units, namely the Allianz Life Indonesia Insurance. The study was conducted using primary data, both observations and use of records and reports owned by the company. Data obtained and analyzed by descriptive method with a qualitative approach. The results obtained from this study are that the operational mechanism of Allianz Life Indonesia's insurance in general is in accordance with Islamic principles, but it needs some further research on the tabarru of premium payments on allisya protection products, which payments begin on the 13th month, while based on national fatwas Tabarru Islamic Premium Payment is carried out since the first month of membership.

Purpose: Our research aims to delve into the influence of diverse national cultures on the consumption of life insurance across various countries. We will conduct a comprehensive analysis, drawing on Hofstede's cultural dimensions, to understand how national cultural dimensions shape life insurance consumption's landscape in developed and developing nations. Design/methodology/approach: This study utilized data from 57 countries from 1996 to 2020 and employed a comprehensive set of regression models in our analysis, encompassing pooled Generalized Least Squares (GLS), Feasible Generalized Least Squares (FGLS) after accounting for autocorrelation and heteroskedasticity, random GLS with control for country-specific autocorrelation, the Fama-MacBeth model, and cross-sectional analysis employing means of time series. Findings: Uncertainty avoidance, long-term orientation, and indulgence significantly influence life insurance demand. The impact of uncertainty avoidance and indulgence varies between developed and developing countries. Variables such as dependency ratio, the percentage of the Muslim population, tertiary education, and world governance indicators display differing effects in developed and developing nations. Conversely, national income, social security, bank development, stock market development, inflation, individualism, and power distance consistently impact life insurance demand in both contexts. Research limitations/implications: Limitation of this study lies in the utilization of static national cultural dimensions, without considering their gradual fluctuations. Our findings are useful for life insurance managers to formulate product launch plans tailored to countries with distinct cultural characteristics. Our findings remind investors in insurance companies to exercise caution once the insurance company tends to enter into developed countries which score high in IVR or MAS, or developing countries with high PDI or UAI scores. Originality/value: This paper provides a comprehensive empirical analysis of the determinants of life insurance expenditures in developed and developing countries, which fills a gap in the literature and helps scholars, insurance practitioners, and policymakers to understand more comprehensively the insurance needs of people in different cultures.

After the so-called «Spring of Nations», Ukrainians in Halychyna tried to revive their national life. In addition to the political party «Main Ruska Rada», the educational organization «Halytsko-Ruska Matytsa», and some others, Halychynians set up the Ukrainian insurance company «Dniester», which was to protect the economic interests of Ukrainians in Halychyna. While communicating with local governments, the Society drew their attention to the implementation of current laws on the use of the Ukrainian language. The Society «People's Council» paid special attention to the functioning of the language in the main state local bodies, in particular in the Lviv City Hall and the Finance Directorate. It is with these institutions that the insurance company most often dealt, defending the daily needs of the local population. The Society «People's Counsil» considered these bodies to be political institutions that, in their relations with citizens, had to comply with the current regulations on the Ukrainian language as the government language. Local governments neglected the Ukrainian language, and this gave «Dniester» grounds to complain to higher authorities, including the High Tribunal in Vienna, the Lviv Governorate and so on. Despite the fact that these institutions issued orders in favor of the Ukrainian language, local governments did not comply with them.

Credibility theory is used widely in group health and casualty insurance. However, it is generally not used in individual life and annuity business. With the introduction of principle-based reserving (PBR), which relies more heavily on company-specific experience, credibility theory is becoming increasingly important for life actuaries. In this paper, we review the two most commonly used credibility methods: limited fluctuation and greatest accuracy (Bühlmann) credibility. We apply the limited fluctuation method to M Financial Group’s experience data and describe some general qualitative observations. In addition, we use simulation to generate a universe of data and compute Limited Fluctuation and greatest accuracy credibility factors for actual-to-expected (A/E) mortality ratios. We also compare the two credibility factors to an intuitive benchmark credibility measure. We see that for our simulated data set, the limited fluctuation factors are significantly lower than the greatest accuracy factors, particularly for low numbers of claims. Thus, the limited fluctuation method may understate the credibility for companies with favorable mortality experience. The greatest accuracy method has a stronger mathematical foundation, but it generally cannot be applied in practice because of data constraints. The National Association of Insurance Commissioners (NAIC) recognizes and is addressing the need for life insurance experience data in support of PBR—this is an area of current work.

The insurance industry has multidimensional functions in a modern economy, interacting with many aspects of business activities and daily human life. Insurance is also an important mechanism for redistributing funds in economy, providing compensation for unplanned losses that are the subject of insurance. At the same time, generally speaking, the insurance sector contributes to strengthening and stabilizing the business of other entities in the general economy. The issue of the quality of information presented to the decision-making process is studied at various levels and remains topical, as the relevance of managerial decisions is significantly influenced by the information provided by the managerial accounting information system. The research methodology of the article includes the study of materials published on the subject at national and international level, the analysis of the regulatory framework in the field, the study of business processes specific to the activity of the insurance company and the application of own experience in the managerial and financial field.

Emmett Jay Scott was private secretary to Booker T. Washington and later became secretary treasurer of Howard University. He was involved in numerous business activities, ranging from the establishment of the National Negro Business League to the founding of an investment clearing-house, an insurance company, and an overseas trading firm. Scott also promoted the black township of Mound Bayou and backed African American entertainment enterprises. His business activities were largely unheralded, and the frustrations he encountered illustrate both the obstacles and the opportunities for black entrepreneurs in the first half of the twentieth century.

AbstractThis paper examines international developments in life insurance generally accepted accounting practice (GAAP) for policy valuation and profit recognition in four major Anglo-American markets—the U.K., Australia, the U.S.A. and Canada. Each valuation method examined has its advantages and disadvantages with respect to the needs of preparers and users of the annual corporate reports of life insurance companies. The paper documents that the statutory basis and U.S. GAAP are considered to have substantive deficiencies. In contrast, the U.K. accruals method, the Australian margin on services method and Canadian GAAP have much to commend them, particularly with regard to their flexibility to accommodate valuation adjustments for unexpected events. Nevertheless, from the preparers' point of view, the systems which would have to be developed to facilitate the U.K. accruals and Australian margin on services methods would be difficult and costly to implement. Profit reporting under Canadian GAAP is also sensitive to changes in actuarial reserving assumptions. The authors conclude that, since national preferences in actuarial and accounting practices are inevitable and because the product-market structures of life insurance markets are so distinctive, international harmonisation of life office GAAP is unlikely to occur for a very long time.

Frank Lloyd Wright's rigid-core high-rise structures, initiated with the project for the National Life Insurance Company building of 1924, have their closest structural and iconographical analogue in one type of Japanese pagoda, exemplified by that at Horyu-ji. This association signals a previously undetected instance of Japanese influence on Wright's work.

Sharia Insurance according to a binding ruling in religious matters (fatwa) of the National Shari'ah Board of the Indonesian Ulama Council no: 21 /DSN-MUI/ X / 2001 is a mutual effort to help among a number of people/parties through investment in assets or tabarru' which provides a pattern of return to face certain risks through engagement in accordance with the sharia. PRUlink sharia is an insurance product associated with sharia-based investment. PRUlink Syariah is designed to meet the society's need for future financial designs in accordance with Islamic principles of sharia. There are two types of product of PRUlink Syariah insurance, namely PRUlink Syariah Investor Account and PRUlink Syariah Assurance Account. Kind of Product in PRUlink Syariah is contract between policy holders using contract of tabarru which is called hibah and the owner of the policy/participant premises sharia insurance company using contract of tijarah called wakalah bin ujrah. In sharia insurance there is a surplus sharing that will be distributed to customers calculated at the end of the calendar year. This can be obtained if there are more funds than tabarru' accounts that have been reduced by claims and debt to the company if any. How is PRUlinksyariah managed in Prudential? The result of the research shows that PRUsyariah premium management in Prudential is separated by two accounts, namely tabarru' account and investment account. The own fund is managed by Eastpring Investment, that is manager company from Asia prudential, while allocation of fund is invested in stocks and obligation which is in accordance with sharia principles contained in the Jakarta Stock Exchange. For the choice of investment in PRUsariah, there are three options of investment, namely Sharia-Rupiah Equity Fund, Sharia-Rupiah Managed Fund or Sharia-Rupiah fixed Income fund, in accordance with the choice of the next participant. From the investment result the participant agrees to pay tabarru’ contribution directly input into tabarru' account. Tabarru’ funds are fully owned by participants and used to pay claims participants claim at any time, but if there is tabaaru’ funds excess with claims total in one year as of 31 December paid, then tabarru’ surplus or that is called surplus will be distributed participants that meet the requirements to get the surplus.

The sea is of paramount importance in the life of man and peoples. Since ancient times, it has represented a tool for communication between nations, a link for civilizational meeting between them, and a source of sustenance. Man’s need and interest in exploiting this wealth moves his curiosity and ambitions to think and search for means that contribute and help in expanding the scope of maritime exploitation and consolidating relations between countries more and more. The maritime field was among the important areas touched by industrial and technological development, especially in the field of maritime transport, which led to the emergence of giant ships capable of embarking on sea voyages and thus moving foreign trade in a positive way. The aim of the research is to know the extent to which ship hull insurance is related to the liquidity and profitability of the National Insurance Company, and where the main research problem is manifested in the extent to which ship hull insurance is linked to the liquidity and profitability of the National Insurance Company. Only the research relied on the questionnaire as a tool for all data and information from the sample of 64 and those who have responsibility are (General Director, Department Director, Division Officer, Unit Officer) and the statistical program was used spss 21 in the calculation standard deviation, simple linear regression, testF ) R² (. The conclusions reached by the research are the evaluation of the degree of risk surrounding the ship and the evaluation of the degree of classification in the classification record is based on which the insurance price for the structures of marine vessels is determined, which shows that the degree of risk varies up and down according to the type of ship, origin, shipping lines, and the experience of the crew and the master. The results of the study also showed the existence of a strong correlation between the liquidity variable and profitability in the respondents' response to the research sample in the National Insurance Company, as there is no profitability without the presence of liquidity and good liquidity expresses the company's ability to meet the payment of its obligations. (*) An extracted thesis, which is part of the requirements for obtaining a higher diploma equivalent to a master’s degree. There are also a number of recommendations, including; Adoption of a unified plan for all insurance branches. To measure the liquidity risk in order to ensure that the company is protected from bankruptcy or its exit from the insurance market in the event of a financial crisis again.

The declining state of the financial market in recent years has strengthened the population's distrust of various financial instruments. Many continue to keep money in cash and in bank deposits, but this does not generate income, or it only covers inflation. The state strives to create new investment solutions that will contribute to attracting money from the population to the economy. Investment life insurance is a significant factor in the development of the national economy, since insurers' funds are directed to investments in government securities and shares and bonds of Russian companies. The mandatory risks included in the ILI agreement are the survival of the insured person, as well as his death. The sum insured upon the occurrence of the risk is paid in 100% of the insurance premiums paid, plus the investment income accumulated by the time of the death of the insured is charged. The article discusses the main problems of reducing the demand for investment life insurance, as well as the ways of its development. Including the main problem with not receiving income from investments. It is proposed to introduce a minimum rate of return, which will have a positive effect on the credit of trust of the insurance company.

This review article is devoted to the study of innovative strategies for managing the activities of insurance companies. In the condi-tions of risky environment, rather high probability occurrence of threats of natural and technogenic character, problems concerning the necessity of a scientific substantiation of the process of the insurance market stakeholders’ interaction aggravate. It is established that insurance in the world economic space is an indispensable financial and economic tool for neutralizing a variety of risks, especially given today’s the socio-economic, financial, epidemiological dangers. It is proved that despite the key parameters’ positive dynamics of the Ukrainian insurance market development for 2009-2019, there is a need to intensify business and investment activity of its participants. The competitive environment of the insurance market requires insurance companies to implement innovative management strategies focused primarily on solving two interrelated problems: firstly, the expansion of property risks’ insurance coverage, as well as risks related to citizens’ life, health and ability to work, secondly, the formation of the insurers’ solvency and ensuring an acceptable level of insurance operations’ profitability in terms of certain types of insurance. It is determined that one of the primary tasks of the insurance company’s management is the management of its business processes aimed at forming a model of customer-oriented behaviour in relation to potential customers. The article emphasizes the need to use a variety of innovative management strategies to achieve medium-term and long-term goals of the company in the insurance market. In particular, the expediency of diversification and the use of alternative pricing strategies for insurance services for long-term and general types of insurance is argued. Proposals aimed at digitalization of the insurance market and wide application of FinTech technologies in the field of insurance services are formulated: automated underwriting, IOT-technologies; blockchain in insurance. Summarizing the results of the study, the author’s vision of the further insurance relations’ functioning of in society is specified. Keywords: risks, insurance company, insurers, insurance protection, insurance market stakeholders, management. Статтю присвячено дослідженню інноваційних стратегій управління діяльністю страхових компаній. В умовах ризикогенного середовища, досить високої ймовірності виникнення загроз природного та техногенного характеру загострюються проблеми щодо необхідності наукового обґрунтування процесу взаємодії стейкхолдерів страхового ринку. Аргументовано, що страхування у світовому економічному просторі є незамінним фінансово-економічним інструментом нейтралізації найрізноманітніших ризиків, особливо зважаючи на соціально-економічні, фінансові та епідеміологічні небезпеки сучасності. Визначено, що одним із першочергових завдань менеджменту страхової компанії є управління її бізнес-процесами, спрямованими на формування мо-делі клієнтоорієнтованості відносно потенційних клієнтів. Наголошено на необхідності використання різноманітних інноваційних стратегій управління для досягнення середньострокових та довгострокових цілей компанії на страховому ринку. Зокрема, аргу-ментовано доцільність здійснення диверсифікації та використання альтернативних стратегій ціноутворення на страхові послуги з довгострокових та загальних видів страхування. Сформульовано пропозиції, спрямовані на цифровізацію страхового ринку та широке застосування FinTech-технологій у сфері страхових послуг: автоматизований андерайтинг, ІОТ-технології; блокчейн у страхуванні. Узагальнюючи результати проведеного дослідження, конкретизовано авторські підходи до подальшого функціонування страхових відносин у суспільстві.Ключові слова: ризики, страхова компанія, страхувальники, страховий захист, стейкхолдери страхового ринку, управління.

The Science of Difference examines life insurance companies' significant impact on the development of systems of human classification and discrimination in modern America. It pays closest attention to the tools employed by life insurance companies to enable and justify their discriminatory practices, tracing their evolution over the course of the nineteenth and early twentieth centuries. Companies used life tables to think about sectional difference prior to the civil war; they collected statistics to defend the propriety of racial discrimination; and they revolutionized risk by inventing the medical “impairment.” Drawing on company archives and personal papers, as well as a wide range of publications, the dissertation describes corporate research in the financial industry, argues for the importance of cultural factors in tracing business history, and shows how the industry built a national statistical community with tools designed to measure and price human difference.

ABSTRAK Perkembangan industri asuransi syariah saat ini mengalami pertumbuhan yang cepat sejalan dengan perkembangan perbankan syariah di Indonesia. Meski memiliki catatan pertumbuhan yang baik setiap tahunnya, bukan berarti perusahaan asuransi syariah memiliki kinerja keuangan yang baik. Maka, penelitian ini bertujuan untuk mengetahui perbedaan kinerja asuransi full jiwa dan perusahaan asuransi jiwa unit syariah dengan menggunakan rasio-rasio pada Early Warning System dan metode RBC untuk peninjauan pada tahun 2015-2020 di Indonesia. Uji Mann-Whitney digunakan sebagai metode analisis data untuk menjawab tujuan dalam peneltiian ini. Hasil analisis kinerja keuangan menunjukkan bahwa adanya perbedaan yang signifikan pada kinerja keuangan perusahaan asuransi jiwa full syariah dan perusahaan asuransi jiwa unit usaha syariah jika dilihat menggunakan Retention Ratio, rasio cadangan teknis, dan rasio kecukupan dana. Di sisi lain, tidak ditemukan perbedaan yang begitu signifikan antara kinerja perusahaan asuransi jiwa full syariah dan perusahaan asuransi jiwa unit usaha syariah dalam hal Solvency Margin Ratio, rasio beban klaim asuransi, rasio likuiditas, tingkat pertumbuhan premi, dan RBC. Hasil penelitian ini dapat menjadi gambaran bagi dan pertimbangan bagi pemangku kebijakan untuk meningkatkan kinerja perusahaan asuransi syariah di Indonesia. Kata Kunci: Asuransi Syariah, Early warning System, Risk-Based capital, Uji Mann-Whitney. ABSTRACT The development of the sharia insurance industry is currently experiencing rapid growth in line with the development of sharia banking in Indonesia. Although it has a good record of growth every year, it does not reflect that Islamic insurance companies have a good financial performance. Thus, this study aims to determine the differences in the performance of life insurance and sharia unit life insurance companies by using the ratios in the Early Warning System and the RBC method in the period 2015–2020 in Indonesia. The Mann-Whitney test was used as a data analysis method. The results show that there is a significant difference in the financial performance of a full sharia life insurance company and a sharia business unit life insurance company when viewed using the Retention Ratio, technical reserve ratio, and fund adequacy ratio. In addition, there is no significant difference between the performance of a full sharia life insurance company and a sharia business unit life insurance company in terms of Solvency Margin Ratio, insurance claim expense ratio, liquidity ratio, premium growth rate, and RBC. The results of this study could portray policymakers to improve the performance of Islamic insurance companies in Indonesia. Keywords: Sharia Insurance, Early Warning System, Risk-Based Capital, Mann-Whitney Test. DAFTAR PUSTAKA Adhita, O., Fauziah, E., & Azib, A. (2017). Analisis perbandingan kinerja keuangan berdasarkan rasio keuangan early warning system pada PT prudential life insurance syariah dan PT asuransi bringin jiwa sejahtera syariah. Prosiding Hukum Ekonomi Syariah, 3(1), 155–161. https://doi.org/10.29313/SYARIAH.V3I1.5436 Amani, Z. A., & Sukmaningrum, P. S. (2019). Kinerja keuangan pada perusahaan asuransi syariah di indonesia dan perusahaan asuransi syariah di Malaysia periode 2013-2015. Jurnal Ekonomi Syariah Teori dan Terapan, 5(8), 645. https://doi.org/10.20473/vol5iss20188pp645-663 Awaliyah, H., Barnas, B., Akuntansi, J., & Bandung, P. N. (2020). Perbandingan kinerja keuangan perusahaan asuransi syariah berdasarkan early warning system dan risk-based capital pada PT asuransi jiwa syariah jasa mitra abadi tbk sebelum dan sesudah go public. Journal of Applied Islamic Economics and Finance, 1(1), 1–14. https://doi.org/10.35313/JAIEF.V1I1.2386 Boitan, I. (2012). Development of an early warning system for evaluating the credit portfolio’s quality. A case study on Romania. Prague Economic Papers, 3, 347–362. https://doi.org/10.18267/J.PEP.428 Chen, R., & Wong, K. A. (2004). The determinants of financial health of Asian insurance companies. Journal of Risk and Insurance, 71(3), 469–499. https://doi.org/10.1111/J.0022-4367.2004.00099.X Fahmi, I. (2012). Analisis kinerja keuangan. Bandung: CV. Alfabeta. Fitri, A., Sepky, N., Sekolah, M., Ekonomi, T., & Sebi, I. (2016). Kinerja keuangan perusahaan asuransi syariah di Indonesia: Surplus on contribution. Akuntabilitas, 9(1). https://doi.org/10.15408/AKT.V9I1.3590 Hansen, & Mowen. (2005). Management accounting. Jakarta: Salemba Empat. Hidayati, A. A., & Shofawati, A. (2018). Determinan kinerja keuangan asuransi syariah di Indonesia periode 2014-2016. Jurnal Ekonomi Syariah Teori dan Terapan, 5(11), 892–907. https://doi.org/10.20473/VOL5ISS201811PP892-907 Hosen, M. N., Ali, A. H., & Muhtasib, A. B. (2008). Materi dakwah ekonomi syariah. Jakarta: PKES (Pusat Komunikasi Ekonomi Syariah). Kustanti, H., & Indriani, A. (2016). Analisis perbandingan efisiensi bank umum syariah (BUS) dan unit usaha syariah (UUS) dengan metode stochastic frontier analysis (SFA) periode 2010-2014. Jurnal Studi Manajemen Organisasi, 13(2), 140-148. https://doi.org/10.14710/jsmo.v13i2.13405 Mahsun, M., Sulistiyowati, F., & Purwanugraha, H. A. (2011). Akuntansi sektor publik. Yogyakarta: BPFE UGM. Munawir. (1992). Analisa laporan keuangan. Yogyakarta: Liberty. Nurfadila, S., Hidayat, R. R., & Sulasmiyati, S. (2015). Analisis rasio keuangan dan risk based capital untuk menilai kinerja keuangan perusahaan asuransi (Studi pada PT asei reasuransi indonesia (Persero) periode 2011-2013). Jurnal Administrasi Bisnis, 22(1). Ramdhana, D., & Tandika, D. (2018). Analisis perbandingan kinerja keuangan asuransi syariah dan konvensional menggunakan metode risk based capital dan early warning system. Prosiding Manajemen, 0(0), 135–141. https://doi.org/10.29313/.V0I0.9086

Any company producing goods or service pursues the same goal of maximization of profit that passes the increase of revenue and minimization of costs, the SONAS Agency of Isiro can not do without this objective as a rational economic agent who has received the mission on the part of the State and to enjoy a monopoly in the insurance market to the national extent more than five decades. It is to be noted that SONAS is being hit by internal difficulties related to its management and external related to the low level of income of the population, ignorance of the property based insurance in the socio-economic life of household. All these hazards also justifies the low revenue mobilization of the Isiro agency SONAS.

The article defines the competitive advantages and competitive potential of life insurance companies (LICs). It is noted that the insurance business is an important part of the financial and credit system, and the insurance market is an ideal place for the development of this industry. Attention is focused on the fact that the life insurance market in Ukraine is at the stage of formation. The current unstable socioeconomic situation, the military aggression of the russian federation, and the peculiarities of the cultural and historical traditions of Ukrainians are the main obstacles and problems for its development. Based on the carried out SWOT analysis, it is concluded that there are certain problems in the activities of LICs. Along with the spread of global trends in globalization and integration of national markets, automation of operational processes, increased competition, trends that are characteristic features of the Ukrainian insurance market are manifested. It is determined that the management of the competitive potential of LICs depends on the adoption of the right managerial decisions in the formation and use of its competitive advantages. The measures are presented in the form of program-target blocks that will provide the basis for creating a mechanism for managing the competitive potential of LICs. In addition, each of the blocks can be considered as a separate subsystem that consists of different components. The components of management of the competitive potential of LICs are defined. It is determined that the assessment of the insurer’s competitive advantages and competitive potential will be possible only with the help of a systematic assessment, which has a clear basis of comparison. This assessment should take into account not only the financial aspect, but also the results of management, the effectiveness of the use of marketing tools, the quality of insurance services and the service of the insured. Measures to increase the competitive potential of insurance services are presented. It is concluded that one of the important conditions for effective management of the competitiveness of life insurance companies is to determine the competitive advantages and competitive potential of LICs, which in the long run allows to assess the level of competitiveness of an insurance company and develop certain measures to adapt to the needs of the insurance market at all stages of operational activities and management links for a quick and prompt response to external threats.

This study’s purpose is to determine if neighborhood disadvantage, air quality, economic distress, and violent crime are associated with mortality among term life insurance policyholders, after adjusting for individual demographics, health, and socioeconomic characteristics. We used a sample of approximately 38,000 term life policyholders, from a large national life insurance company, who purchased a policy from 2002 to 2010. We linked this data to area-level data on neighborhood disadvantage, economic distress, violent crime, and air pollution. The hazard of dying for policyholders increased by 9.8% (CI: 6.0–13.7%) as neighborhood disadvantage increased by one standard deviation. Area-level poverty and mortgage delinquency were important predictors of mortality, even after controlling for individual personal income and occupational status. County level pollution and violent crime rates were positively, but not statistically significantly, associated with the hazard of dying. Our study provides evidence that neighborhood disadvantage and economic stress impact individual mortality independently from individual socioeconomic characteristics. Future studies should investigate pathways by which these area-level factors influence mortality. Public policies that reduce poverty rates and address economic distress can benefit everyone’s health.

The earliest sickness survey of the US Public Health Service, which started in 1915, was the Service’s first socioeconomic study of an industrial community. It was also the first to define illness as a person’s inability to work. The survey incorporated the Metropolitan Life Insurance Company’s definition of illness, which, instead of sickness rates, focused on duration of illness as a proxy of time lost from work. This kind of survey took place in the broader context of the reform movements of the Progressive Era and the social surveys conducted in the United States, which led to the creation of the Federal Commission on Industrial Relations, where the Service’s sickness survey originated. The Service’s focus on the socioeconomic classification of families and definition of illness as the inability to work enabled it to show the strong link between poverty and illness among industrial workers. The leader of the survey, Edgar Sydenstricker, and the Metropolitan Life Insurance Company came up with new ways to measure the health of the population, which also influenced the Service’s studies of the effects of the Great Depression on public health and the National Health Survey of 1935–1936. (Am J Public Health. 2021; 111(11):1960–1968. https://doi.org/10.2105/AJPH.2021.306454 )

The given statistical data show that the interest of Ukrainians in insurance and the level of financial literacy of the population is growing, trust in insurance services is increasing. However, the crisis related to the COVID-19 pandemic and the economic crisis in 2020 continued to have a moderate impact on insurers. Insurers’ insurance premiums reported to the National Bank maintained an upward trend, but the increase was halved. The problematic consequences of the pandemic for insurers are: reduction of the share of insurance premiums for aviation insurance and property insurance; reducing the number of contracts related to new car insurance; difficulty in the organization of remote customer service by employees of the insurance company, namely the assessors of insurance losses; elimination of small insurance companies that failed to organize quality online services. The pandemic has led to both positive and negative consequences in the activities of domestic insurers. It gave a new impetus to the development of insurance culture among Ukrainian citizens. People began to understand the importance of such a service, especially life and health insurance. Therefore, it can be argued that most insurance companies in the market were able to adjust and find solutions for stable operation in conditions of economic danger. Thus, according to the current process of formation of the insurance market in Ukraine, we came to the conclusion that its further successful development will depend on: effective control over the activities of insurers by the state; strengthening the capital requirements of insurers, their solvency and assets; adaptation of domestic insurance legislation in accordance with the norms, rules and requirements of European and world markets; introduction of innovative insurance technologies and the latest service quality standards in this area; creation of associations of insurers on the most important insurance issues; creation of a comprehensive system of training and retraining; promotion of insurance services among the population.

ABSTRACT The aim of this article was to evaluate the viability of Universal Life insurance (UL) in Brazil from two perspectives: from the individual viewpoint of policyholders, considering different client profiles and investment scenarios; and from the company viewpoint, verifying whether insurers see sales advantages in UL. Thus, despite the lack of definition of the regulations on these contracts by the Superintendence of Private Insurance (Susep), this article’s contribution lies in evaluating UL - a typically American product - in Brazil, using an entirely actuarial methodology, for policyholders and insurers, according to local parameters. The relevance of the article lies in strengthening the support for individuals, companies, and authorities to evaluate the product and discuss its implementation, even identifying the most favorable profiles and scenarios for its development. Although the UL is an individual modality that is widespread in several countries and its design exploits well-defined attractions, the product has not been explored in the national literature. The methodology adoted in this study used fully actuarial modeling, the internal rate of return (IRR), and profit testing. The study reveals that the Brazilian market for UL is viable, especially due to the higher interest rates compared to countries where the product is already widespread. From a demand perspective, the results indicate that the policyholder would be in a more advantageous position acquiring UL than buying life insurance in the private market and investing the surplus in financial assets, due to the hybrid characteristic of the contract, which enables the use of financial returns as discount factors in the insurance portion and operational charges, reducing the opportunity costs linked to the product. With regard to companies, the profit testing results suggest there are stimuli for the supply of UL, provided the operation has a long-term bias. Altering the mortality pattern, policy type, and the company’s investment profile, all the results point in a similar direction.

Good Corporate Governance (GCG) is a system that organizes and controls a company so that it can form added value for all stakeholders. This study aims to determine the application of GCG at PT AXA Mandiri Financial Services (AMFS) which is a joint venture Conventional Life Insurance company between PT Bank Mandiri (Persero) Tbk and National Mutual International Pty. Limited (AXA). The research method used is descriptive qualitative. The results of this study indicate that PT AMFS has implemented GCG in an integrated manner in all business processes. This is evidenced by the transformation in 10 line areas, namely digital services, distribution, health and protection, human resources and culture, information technology systems, data, efficiency, customer experience, and offers (documents and products). PT AMFS also applies the Three Lines of Defense principle to an internal control system that is integrated with risk management. The main line of defense is the directors and all employees of PT AMFS. Second, risk management, compliance and law. Third, internal and external audit.

This paper aims to evaluate the impact of digitalization technologies on the insurance industry in Nigeria. Data were obtained from primary sources only. The primary data were collected through the mailed questionnaires that were administered to selected Chartered Insurers in Nigeria. The questionnaires were designed to reveal issues on digital transformation in Insurance industry in Nigeria. Seventy (70) questionnaires were sent to the respondents across the country in the six Geo-Political zones in Nigeria. It is noteworthy that 45% of the respondents were the Chief Executive Officers of different insurance companies, 30% of them were at Senior Manager Level of the Life Assurance Companies while the remaining 25% were the General Managers of Underwriting, Claims, Marketing and Human Resources Departments. It was found out that Nigerian Insurance companies as well as the NAICOM had transformed more than 40% of their services into digital technology. Besides, the research further revealed that almost every insurance company in Nigeria has a digital platform. The research recommends that the Federal Government should create sufficient budgetary allocation to invest in InsurTech and improve the training of the staff of the Government owned insurance companies such as NICON, Nigeria Reinsurance Corporation, LASACO, on the acquisition of digital skills. This will quickly encourage and mandate the private owned insurance companies to equally invest in InsurTech and arrange digital training for their staff so as to acquire digital skills necessary for the full digital transformation. The National Assembly should also amend the existing Constitutions on big data and recommend strict penalties for cybersecurity breaches. All these will disrupt the insurance services in Nigeria.

Not a day goes by that I don't miss my old life and the old me. To illustrate how my life has changed, I have two brief stories. In 1982, I developed a lending procedure in conjunction with Banker's Life Insurance Company that enabled commercial real estate developers to secure permanent financing for property that had not yet been developed in essence using a permanent loan in place of a construction loan. It fixed the interest rate, at a time when new construction rates were bankrupting many projects and it allowed the developer to invest the excess funds to offset interest expenses. I received national recognition for this loan. In 1989, the police found me wandering around in 15 inches of snow, in below zero weather with no shoes or coat. The officer took me to the hospital because I was obviously disoriented. I didn't even know my name or where I lived. These stories show the disparity between my life as a successful, independent business woman and my life as someone who is chemically disabled.

Purpose: Agricultural insurance has been offered in some developed economies for more than a century. In contrast, the sector remains underserviced in low and middle-income economies. Penetration of agricultural insurance exceeds 1 percent in developed economies but in low and middle- income countries, the agricultural insurance penetration is less than 0.3 percent. The gap between the penetration of non–life insurance and agricultural insurance increases as development status decreases. The purpose of this research work is to outline lessons from developed economies on how capacity building for agriculture insurance is done. Methodology: Relevant books references and journal articles for the study were identified using Google Scholar. The inclusion criteria entailed papers that were not over five years old. Findings: The study findings showed that insurance company’ in enveloped economies sell crop insurance policies through financial institutions or cooperatives, which are particularly important in marketing crop hail insurance. It was also found that in the developed economies, there is a national climate change policy as a means of capacity building for agriculture insurance. This policy helps the government to plan for training of staff and policymakers on how to advise farmers to take agricultural insurance. This policy also help in enhancement of the administrative and technical capacity of government institutions responsible for handling climate change related issues that affect agriculture insurance Recommendations: The study recommend policymakers in developing countries to focus on imperfections on the pricing of agricultural insurance products. This will help policymakers designing public support programs aimed at reducing the cost of insurance thus developing insurance products that are attractive and affordable to farmers and financially viable and sustainable for insurers. The study also recommend developing countries to embrace modern insurance pricing approaches that are based on the credibility theory such as the experience-based approach. This approach has been promoted in several developed countries to cover systemic risks because it allows for the adjustment of the expected loss based on additional credible information such as insured losses of other products. The study further recommend developing countries to promote insurer- insured partnerships.

After the endorsement of the National strategy of rare disease patient health care development for years 2012 - 2013 by the government of the SR on October 24, 2012, it is important for all participants in the process to get involved. (Who are all the participants? - doctors, pharmacists, scientist, national authorities, regulators, health insurance companies, social insurance company, health care and social workers, pharmaceutical industry, but also politicians, patients and patient organizations) Based on the experience and problems which are being solved by patients, it is necessary for POs to focus on areas important for the creation of NP RD in the SR. These are most of all: complex approach to patients based on a multidisciplinary team, inclusion of patients into decision making - an educated patient is a prerequisite for this; specialized services for RD patients and their families; integration of RD patients into existing health care and social system and help lines. Slovak Alliance of Rare Diseases (Alliance RD) was founded and registered at the Ministry of Interior of the SR on December 12, 2011. The reason for its foundation was the effort to solve problems in the area of RDs in a complex and systemic way, which is proved by its involvement in the creation of NP RD in the SR. It houses 12 POs working in the field of RD in Slovakia. The objective of the Alliance RD is to keep improving the health and social life conditions of rare disease patients and their families, to improve the quality of rare disease patients’ lives, and to support their social integration. In close cooperation with EURORDIS - Rare Disease Europe − it took part in EUROPLAN II (2012 - 2015), a project organized by the National conference for the support of the creation of National plan of rare disease patient health care development in Slovakia.

In this article, a theoretical study was carried out related to the analysis of the health insurance system in Ukraine regarding the level of its information transparency and transparency in interaction with private, cooperative clients and the state, which represents the controlling and regulatory authorities. The main goal of this study is an analytical assessment of insurance companies that provide services for voluntary health insurance in terms of openness to users of information about their economic activities, features of the offered insurance policies, their cost, etc. This paper summarizes the arguments and counterarguments within the scientific debate regarding the concept of «transparency» and the benefit received by subjects of economic relations from following the principles of openness and integrity. The urgency of solving this scientific problem lies in the fact that the level of medical protection and the quality of services provided to the population on the basis of the existing state health insurance is at a low level and does not contribute to improving the health, working capacity and quality of life of society. The study of the transparency of the health insurance system was carried out in the following logical sequence: the relevance and problematic of the researched question are determined, as well as the position of scientists regarding this is summarized; a general analysis of the dynamics of net insurance premiums and net insurance payments for 2019-2021 was carried out, for various types of insurance, including medical insurance; the activity of the most rated insurance companies in health insurance was analyzed by the level of insurance premiums and payments as of the end of 2021; a comparative analysis of the insurance products of the companies was carried out and, based on transparency indicators and a scoring system, a conditional division of the analyzed commercial institutions according to the level of information transparency into high, medium and low levels was performed, based on the obtained points with the selection of the most attractive and informationally open institutions; the final stage of the article provides conclusions and own recommendations for solving problematic aspects of the research. Informational data from the official websites of the analyzed insurance companies, open data of the National Bank of Ukraine, and statistical information on the functioning of the insurance market from the Internet became the factual basis for this study. The results of the conducted research can be helpful for individuals who are interested in choosing an insurance company for personal health insurance.

IntroductionChina's National Reimbursement Drug List (NRDL) covers medicines that are included in national health insurance schemes. NRDL updates take into account evidence and recommendations of experts from the fields of medicine, health economics, pharmacy and health policy. A negotiation mechanism between the government and manufacturers was introduced in 2017 to include a more detailed evaluation and negotiation for high cost drugs. However, the values that are considered in NRDL decision making are not well-understood. This study aims to investigate the influence of available evidence and other factors on coverage decisions.MethodsOutcomes of the 2017 and 2018 NRDL negotiations were analyzed. Logistic regression was used to investigate factors associated with listing decisions. Ordinary least squares and Tobit regression were used to investigate factors associated with negotiated price discounts. Independent variables were published cost-effectiveness analysis (CEA), incremental cost-effectiveness ratio (ICER), disease area, burden of disease (disability-adjusted life years), company ownership (domestic or foreign) and regulatory approval year.ResultsTwenty-eight out of sixty-two negotiated drugs had one or more published CEA studies in the English or Chinese language, although neither the presence of a study nor the central ICER estimates were predictive of price discount or listing. A longer time since regulatory approval was a significant predictor of listing (p < 0.05). Disease area (oncology) and ownership (foreign) were significant predictors of a higher price discount (p < 0.01).ConclusionsThe NRDL plays a key role in providing access to healthcare for the 95 percent of China's population that is covered by public insurance. We found several factors that were associated with reimbursement decisions. Many of the medicines in the NRDL negotiation have CEA evidence, although the role of CEA in reimbursement decision making in China remains inconclusive.

Introduction. The current practice of functioning of the medical sector shows the existence of problems that impede the introduction of compulsory health insurance in Ukraine, the effective development of its voluntary form. At the same time, the problems of development of medical insurance under the influence of crisis phenomena of the national economy are deepening. The purpose of the article is to develop recommendations for improving medical reform in Ukraine. Results. The most controversial moment in the reform of health care was the rejection of free medicine, the right to which is enshrined in the Constitution of Ukraine. However, budget medicine in Ukraine will still remain, however, in what volumes and at what stages of provision of medical services or medical care is not yet defined in the Ministry of Health of Ukraine. The negative trend of the contracted health model is the creation of an authorized body that will not only implement health policy but, in fact, formulate this policy: to define state guarantees, needs for medical services and to check the quality of these services. And this is a huge threat, because Ukrainian medicine will be in a worse situation than it is now. We believe that the policy-making function should remain under the Ministry of Health of Ukraine. The negative aspect of modern medical reform in Ukraine is the lack of requirements for the formation of medical treatment protocols. This can be explained by the fact that patients will continue to prescribe treatment that is untrue. Instead, for the health insurance, the insurance company would monitor costs and control the appointment of treatment for the patient, the price of medical services. In this context, we propose to adopt the Law of Ukraine “On Compulsory Health Insurance”, which stipulates and clearly defines the rights and obligations of the insurer, the insurer, the list of services, their price, a single register of insured persons, the formation of the Social Health Insurance Fund and a differentiated approach to categories of the population. Conclusions. The experience of developed countries of the world proves that achieving this goal is possible through the introduction of insurance medicine. Insurance medicine is a real alternative to budget financing, which is no longer capable of ensuring the constitutional right of citizens to receive unpaid health care. The development of health insurance is an objective need, which is dictated by the need to ensure that healthcare receives funds. At the moment, the study of the question of the necessity of introducing compulsory health insurance is probably very relevant to all. Successful market reforms in Ukraine are impossible without the formation of an effectively organized health insurance market that can guarantee the preservation and strengthening of human health, improving the quality of medical services and the level of human life.

Hundreds of children with AIDS are suffering or dying prematurely because they are unable to obtain AZT, a drug that could prolong and improve the quality of their lives.... Experts say AZT, or azidothymidine, the only AIDS drug approved for use in adults and teen-agers, has been tested in children and shown to be just as active in them, prolonging life and even dramatically reversing mental deterioration. Yet the Burroughs Wellcome Company, the drug's manufacturer, has not yet applied for approval to market AZT to children under the age of 12 or to make it available to them under "compassionate use" procedures before marketing approval is granted. As a result, AZT is not available in a pediatric dose, except in clinical trials, and insurance companies and government programs will not pay for its use in children... A company official said Burroughs Wellcome was working as fast as possible to prepare material needed for Federal approval. But Dr. Samuel Broder, director of the National Cancer Institute, who was a key figure in demonstrating that AZT could slow the spread of the AIDS virus, said he was "very disturbed" that Burroughs Wellcome had not applied for approval to market the drug to children.... Nearly, 1,800 cases of children under 12 with AIDS have been reported to the Federal Centers for Disease Control, but experts say many more have gone unreported. About 800 of these children have died. About 300 children are enrolled in clinical trials...

Abstract In the Netherlands, reablement is high on the agenda for inclusion in future health care policy, resulting in more and more care providers wanting to implement reablement into their everyday practice. So far, it has been implemented, resourced and organized in multiple ways. To support the implementation on an (inter)national level, insight is needed into what preconditions and influencing factors are regarding the successful implementation of reablement. Within a qualitative exploratory research design, four focus group interviews were conducted with stakeholders from three Dutch care organizations that have been providing reablement services for at least 6 months prior. Care staff, as well as project leaders, managers, directors, policymakers, and health insurance company representatives, were represented in the interviews. Data were analyzed using the framework method guided by the Consolidated Framework for Implementation Research. In total, 34 stakeholders, distributed over the four focus group interviews, participated in the study. Facilitators included interdisciplinary collaboration, organizational support in terms of leadership engagement and implementation climate, innovation design, and adaptability of the innovation. Barriers included costs and funding of the innovation, time investment (i.e. reporting, number of care visits), and communication. Some factors were listed as both hindering and facilitating such as knowledge and beliefs of care staff, staff’s and clients’ self-efficacy to change, and motivation of clients and family caregivers. These results enhance the understanding of factors influencing the implementation of reablement in community care. The next step is to identify strategies to overcome the identified barriers.

Orthopedic surgeons are usually well-versed in the medical parts of their career, but they may be less so in the financial aspects. The purpose of this article is to present orthopedic surgeons with a list of ten critical financial investments that will help them ensure their financial future and improve their practice. Orthopedic doctors may make educated decisions and develop a sound financial foundation for their careers and retirement by considering these investing alternatives. The article will discuss a variety of investment possibilities, including stocks, bonds, real estate, and alternative investments, as well as how to manage funds wisely to maximize profits and minimize risks. Life Insurance Plan Term life insurance is recommended for doctors due to its affordability and flexibility, but should not be mixed with money back clauses. The ideal life cover amount depends on income, financial obligations, and future goals. Dave Ramsey’s Rule of Thumb suggests getting coverage 10–12 times your income, while the Life Insurance Amount Formula calculates needs by adding outstanding debts, projected family expenses such as kid’s education and marriage, annual expenses, and deducting current savings and investments. The White Coat Investor recommends a 30-year term life insurance policy for simplicity, and it is generally wise to have life insurance until children become financially independent and you have enough money to care for your spouse. Mediclaim Policy Mediclaim coverage is crucial for orthopedic surgeons and their families in India to cover the financial impact of medical emergencies. Factors to consider include the sum insured, network hospitals, and pre-existing sickness coverage. For major cities like Delhi or Mumbai, an insured amount of Rs 10 lakh per person is recommended. For households of two adults and one child, Rs 30 lakh is recommended. Pre-existing diseases disclosure is essential to avoid reimbursement issues like refusal of claim. Health insurance portability allows policyholders to switch insurance companies for better coverage or services, without forfeiting any accrued renewal benefits waiting period for pre-existing diseases. However, portability is only available 45 days before policy renewal. Fixed Deposit Fixed deposit plans provide greater interest rates than savings accounts, making them an appealing long-term investment option. Early withdrawals, on the other hand, may result in penalties or lesser returns. Before investing, it is important to examine the bank’s trustworthiness, interest rate offered, scheme duration, and other terms and conditions. It should be noted that the interest produced by these schemes is taxable. Gold and Gold Bonds Gold and Sovereign Gold Bonds (SGBs) are attractive investment alternatives for doctors in India because they provide a buffer against inflation and a secure harbor for funds. Gold is a desirable asset that gains with time, but there are expenditures to consider such as storage and maintenance. SGBs, which were introduced in November 2015, are government securities priced in grams of gold with a set annual interest rate of 2.5% and an 8-year maturity with tax advantages. Individuals, HUFs, trusts, universities, and charity institutions are all eligible investors. Mutual Funds Mutual funds have several benefits, including diversification, expert management, liquidity, and cost. Doctors can invest in mutual funds and can invest on their own or use an advisor. Systematic Investment Plans (SIPs) are a popular option for doctors to engage in mutual funds because they allow them to contribute small sums on a regular basis and profit from the power of compounding. Before investing, it is critical to assess several mutual fund options, such as direct investment, which lowers the expense ratio, and consider variables such as the fund’s performance history, fund manager track record, fund stock portfolio, and investment strategy. One of the simplest methods is to invest in index mutual funds, which provide identical returns to indexes such as the Nifty50. Equity Stocks India’s economic might is increasing. As a result, equity stocks provide long-term development and capital appreciation potential for investors. Doctors should examine market risks carefully and diversify their investment portfolios. They can invest in large-cap stocks with a track record of consistent growth, such as Asian Paints and Pidilite, and equities traded funds, such as Nifty Bees, or seek professional assistance in developing a portfolio that is matched with their financial goals and risk tolerance. SIPs are popular for investing in equities companies. Due to stock market volatility, the investment horizon should be more than 5 years to expect returns of 12–15%. Professional Indemnity In India, professional indemnity insurance is essential for orthopedic specialists since it protects legal responsibilities resulting from medical malpractice lawsuits. It shields doctors against financial risks such as judgments, arbitration fees, medical harm, punitive damages, restitution, attorneys’ fees, legal costs, and penalties. For orthopedic surgeons, the insurance should give continuity of coverage for liability from previous years of practice, offer out-of-court settlement, and have a minimum sum insured of 1 crore. The sum guaranteed is also determined by insurance period (any one year AOY) and accident times (any 1 time AOT). For complete coverage and dependable service, it is critical to renew the policy on time and to pick a renowned insurance provider. Various medical organizations, such as Maharashtra Orthopaedic Associations, have professional indemnity programs. Car Insurance Before purchasing car insurance for doctors in India, it is crucial to consider the following factors: company reputation, coverage, exclusions, deductible, claim process, premium payment frequency, add-on options such as cashless facility, customer service, claim settlement ratio, and online buying option. The Insured Declared Value is the market price of a car and the maximum sum insured if the car is stolen or damaged beyond repair. The insurance premium is also directly proportional to IVD; hence, an appropriate IVD is important. The Incurred Claim Ratio (ICR) is the total claim amount paid by the insurance company in relation to the total premium amount collected in a financial year. A high ICR indicates good compensation settlement. By considering these factors, doctors can make informed decisions and get the most value for their money when purchasing car insurance in India. Real Estate Residential, commercial, real estate crowdfunding, raw land, and real estate investment trusts are all types of real estate investments in India. These investments enable investors to diversify their portfolios while also generating rental income or capital appreciation over time. Doctors should evaluate their property’s location, thorough property registration documents check, and any legal concerns relating to the property to make informed judgments. They should define their investment goals and risk tolerance, as well as perform extensive study on market trends, property valuations, demographics, and possible future growth. Retirement Planning Retirement planning is important in India for a variety of reasons, including financial stability, addressing increased life expectancy, managing inflation and healthcare expenses, taking advantage of tax breaks, and gaining peace of mind during the post-retirement era. Early in their careers, Indian doctors should begin planning for retirement, diversifying their retirement portfolio to spread risk and maximize returns, considering tax-efficient retirement planning strategies such as the Public Provident Fund and the National Pension System, budgeting for health-care expenses, and seeking professional advice. Starting early investment uses power of compounding which dramatically increase their retirement savings over time, while diversifying their portfolio can help balance risk and reward. Seeking competent financial counsel can assist Indian physicians in making educated judgments and navigating the complex retirement planning alternatives. Conclusion Finally, we must diagnose our own financial literacy. We must learn and study to clear blind spots in our financial knowledge. Finally, just as we utilize our medical knowledge to operate and treat our patients, we should use our financial knowledge to be financially independent, wealthy, and to assist others in achieving their life goals.

Background: The four main diagnostic groups for palliative care provision are cancer, chronic obstructive pulmonary disease, heart failure and dementia. But comparisons of costs and care in the last year of life are mainly directed at cancer versus non-cancer or within cancer patients. Aim: Our aim is to compare the care and expenditures in their last year of life for Dutch patients with cancer, chronic obstructive pulmonary disease, heart failure or dementia. Design: Data from insurance company Achmea (2009–2010) were linked to information on long-term care at home or in an institution, the National Hospital Registration and Causes of Death-Registry from Statistics Netherlands. For patients who died of cancer ( n = 8658), chronic obstructive pulmonary disease ( n = 1637), heart failure ( n = 1505) or dementia ( n = 3586), frequencies and means were calculated, Lorenz curves were drawn up and logistic regression was used to compare patients with high versus low expenditures. Results: For decedents with cancer and chronic obstructive pulmonary disease, the highest costs were for hospital admissions. For decedents with heart failure, the highest costs were for the care home (last 360 days) and hospital admissions (last 30 days). For decedents with dementia, the highest costs were for the nursing home. Conclusion: Patients with dementia had the highest expenditures due to nursing home care. The number of dementia patients will double by the year 2030, resulting in even higher economic burdens than presently. Policy regarding patients with chronic conditions should be informed by research on expenditures within the context of preferences and needs of patients and carers.

Abstract Research confirms serious and concerning health implications for lonely and socially isolated older adults. Studies consistently demonstrate that older adults who are lonely or socially isolated have higher rates of depression, more health conditions, and greater mortality. AARP Services, Inc. (ASI) and UnitedHealthcare (UHC) are committed to the health and well-being of insureds in AARP® Medicare Supplement Plans insured by UnitedHealthcare Insurance Company (for New York certificate holders, UnitedHealthcare of New York), recognizing that health and wellness should be promoted on a holistic level to ensure successful aging. As part of this commitment, a research initiative entitled Aging Strong 2020 has been developed. Its purpose is to impact insureds’ personal and social investments in their well-being Thus a related series of interventions are aiming to increase resilience by focusing on enhanced purpose in life, social connectedness, and optimism. This symposium will specifically discuss these efforts related to social connectedness and how they have improved well-being among lonely older adults. First discussed is the prevalence and outcomes of loneliness in a large national survey. Interventions include use of animatronic pets, a telephonic reminiscent memory program, and an online self-compassion mindfulness program. Findings from these initiatives demonstrate that interventions designed to improve loneliness and well-being among lonely older adults can contribute to the holistic model of health.

Abstract Introduction Persons with hemophilia require complex medical care by a multi-disciplinary team throughout life. There are opportunities for Hemophilia Treatment Centers (HTC) to enhance the care of persons with hemophilia through participation in quality improvement (QI) initiatives. Maintaining comprehensive care and excellent health outcomes are national priorities for Health Resources and Services Administration (HRSA) and the American Thrombosis and Hemostasis Network (ATHN), the National Hemophilia Program Coordinating Center (NHPCC). Rady Children's Hospital San Diego (RCHSD) HTC participated in the NHPCC Dartmouth Improvement Program pilot program with the aim to develop QI capabilities within the HTCs to enhance the care of persons with hemophilia. Methods RCHSD participated in the NHPCC Dartmouth Improvement Program starting in December 2015. A QI team was established including the HTC medical director, nurse case managers, pediatric social worker and the social worker of the collaborating adult HTC. The QI team was coached by an expert TDIMA coach and a "coach in training" from another HTC. The team learned QI methods through in person training, web-based training and weekly team meetings with the coaches. The team assessed HTC data (The 5Ps-purpose, patients, professionals, processes, and patterns) to gain system knowledge and insights to determine a QI theme, global aim, specific aims and associated PDSA cycles. Results The RCHSD HTC QI team established a QI theme to focus on the transfer from pediatric to adult care. The Global Aim of the team is to improve autonomous communication in RCHSD HTC. The process begins with the 12 year old comprehensive clinic visit and ends with a new patient visit at an adult HTC. By working on the process, we expect patients to have the communication skills to be able to arrange medical insurance, call the home care company to order factor and to communicate their health and personal care needs to adult health care providers. We developed four specific aims which are in various stages of testing in PDSA cycles (Table 1). For Aim 1, we found that patients have only basic knowledge of insurance information. For Aim 2, we found that we needed to adjust our clinic process to make sure that patients receive their "after visit summary" that includes the insurance information prior to leaving clinic. Conclusions We developed a QI program within RCHSD HTC focused on improving transfer of care. Once we have completed the specific aim PDSA cycles we will standardize the new and improved procedures. We will continue to develop the program based on internal needs assessment and family input. This training model may be adapted by other HTCs to enhance patient care. Disclosures Thornburg: Mast Pharmaceuticals: Research Funding; Bayer Pharmaceuticals: Research Funding; Shire: Consultancy; Biogen Idec: Other: Data Safety Monitoring Board; Bluebird inc: Other: Data Safety Monitoring Board.

Abstract Background Patients with sickle cell disease (SCD) experience a wide range of complications thought to be due to the systemic impact of chronically inflamed vasculature, ongoing haemolysis, multi-cellular adhesion and ischemic damage. These complications impact the health-related quality of life and the life expectancy. One of the most impactful complications is the vaso-occlusive crisis (VOC). Evidence of the relationship between VOC occurrence and the incidence of SCD-related complications is still emerging. Aims To assess the association between hospitalised VOC rates and acute and chronic complications in SCD patients. Methods This study was a retrospective observational cohort study using the French national health insurance's claims database. This database gathers information on hospital records, and primary and secondary care. Between 01-01-2012 and 12-31-2018, all patients 16 years and older suffering from SCD (through a hospital record or Long-Term Disease status with diagnostic ICD-10 codes D57.0-2) were included in the study. Participants were followed-up for at least one year and until 12-31-2018. A hospitalised VOC was defined as a hospital stay of at least one night with a primary or related diagnosis of sickle-cell anaemia with crisis (D57.0), preceded by a transit through the emergency room. The VOC annual rate was defined as the total number of VOCs during the follow-up divided by the number of follow-up years. Patients were categorised by the annual rate of VOCs they experienced into three groups: &lt;1; 1 to &lt;3; ≥3 VOCs per year. Complications [1] known to be experienced by patients with SCD and leading to a hospitalisation were identified during the follow-up using ICD-10 codes reported in the hospital discharge records. Cox proportional hazards models using age as the time scale were used to study the effect of the annualized rate of hospitalised VOCs on the risk of complications, adjusted for sex. Results A total of 17,726 patients were included in the study, of which 65.3% were female -a high proportion partly due to inclusion of women at time of pregnancy hospital stay. Ages ranged from 16 to 99 years and the average age was 35.0 years (±17.8). Overall, 90.3%, 7.4%, and 2.3% of patients experienced &lt;1, 1 to &lt;3, or ≥3 VOCs per year during the follow up period, respectively. Over a median follow up of 7 years, the most common complications requiring a hospital admission were acute chest syndrome (ACS) (18%), sepsis (16%), acute kidney injury (12%), gallstones (10%), and eye disorder (7%). During the follow-up period, compared to &lt;1 hospitalised VOC per year, patients with a rate of ≥3 hospitalised VOCs per year had a statistically significant higher risk of inpatient treated complications: a 19.2 [95%CI 16.0;22.9]-time increase in the risk of osteonecrosis, 16.7[95%CI 12.0;23.2] of pulmonary hypertension, 16.4 [95%CI 13.2;20.5] of pulmonary embolism, 13.3 [95%CI 12.0;14.8] of ACS, 12.8 [95%CI 8.2;20.2] of heart failure, 12.0 [95% CI 10.0;14.4] of eye disorder, 10.0 [95% CI 8.9;11.2] of sepsis, 9.7 [95% CI 8.3;11.4] of acute kidney injury, 6.7 [95% CI 5.7;7.9]of gallstones, 6.3 [95% CI 4.3;9.0] of priapism, 6.1 [95% CI 4.6;8.0] of liver complication, 5.9 [95% CI 4.3;8.0] of central nervous system complications, 3.4 [95% CI 2.0;5.8] of dialysis, 3.2 [95% CI 2.2;4.6] of stroke.. Conclusions Patients frequently experiencing VOCs are at much greater risk of hospitalization for some chronic complications compared to patients rarely experiencing VOCs. The highest association were found for osteonecrosis and pulmonary hypertension or embolism. It could be an additional reason to reinforce treatment of SCD patients with recurrent VOCs. [1] ACS, Sepsis, Acute Kidney Injury, Gall stones, Eye disorder, Osteonecrosis, Liver complication, Stroke, Pulmonary embolism, Dialysis, Central nervous system, Pulmonary hypertension, Heart failure, Priapism, Kidney transplantation, Cardiomegaly Disclosures Arlet: Novartis company: Consultancy, Honoraria, Research Funding; Pfizer: Honoraria; Addmedica: Research Funding. Lennon: HEVA: Ended employment in the past 24 months; IQVIA (contractor to JANSSEN Pharmaceuticals): Current Employment; WHO International Agency for Research on Cancer: Ended employment in the past 24 months. Bailey: Novartis pharmaceuticals: Current Employment. Herquelot: Pharmaceuticals and medical devices companies (BMS, MSD, Merck Sante, Janssen, Cook, Novartis, Pfizer, Takeda, ...): Other: Grants or contracts for our CRO from pharmaceutical and MD industries for research study. Lamarsalle: Pharmaceutical and medical devices comapnies (BMS, BSCI, AstraZeneca, Janssen, Merck, Novartis, Pfizer, Roche, ...): Other: Grants or contracts for our CRO from pharmaceutical and MD industries for research study. Raguideau: Pharmaceutical and medical devices companies (BMS, MSD, Merck Sante, Janssen, Cook, Novartis, Pfizer, Takeda, ...): Other: Grants or contracts for our CRO from pharmaceutical and MD industries for research study. Bartolucci: ADDMEDICA, NOVARTIS, ROCHE, GBT, Bluebird, EMMAUS, HEMANEXT, AGIOS: Consultancy; NOVARTIS, ADDMEDICA, JAZZPHARMA: Other: Lecture fees; Novartis: Other: Steering committee; ADDMEDICA, foundation Fabre, NOVARTIS, Bluebird: Consultancy, Research Funding; INNOVHEM: Other: Cofounder.

BackgroundThe daily dose of oral glucocorticoids (OCS) is associated with damage in Systemic Lupus Erythematosus (SLE), and OCS reduction is a major goal of SLE care. However, evidence regarding the real-world use of OCS in nation-wide populations are currently lacking.ObjectivesThe aim of this study was to analyze the use of OCS in French patients with SLE, at the national level, using medico-administrative data.MethodsThis study used the French health-insurance claims database (SNDS), which contains pseudonymized individual data for over 66 million people. SLE patients were identified with the ICD-10 diagnosis code for SLE (M32), documented as a chronic condition or associated to hospital stay. Included SLE patients were defined as patients alive on January 1st2020 whenever the SLE diagnosis occurred. SLE comorbidities and OCS complications were identified through validated algorithms. Real-world use of treatments was identified through drug deliveries in pharmacies and daily OCS doses (expressed in prednisone-equivalent) were calculated for the year 2019. Comparisons were made to age- and gender-matched controls without SLE from the general population.ResultsA total of 32,173 patients with SLE (mean age 49.9 ± 16.0 years; 86.1% women) were alive on January 1st2020, with a mean disease duration of 7.1 ± 6.2 years.Among these prevalent SLE patients, 48.2% were treated with OCS. The mean daily dose of OCS was below 5 mg/day in 35.7%, between 5 and 7.5 mg/day in 6.4% and above 7.5 mg/day in 6.1%. OCS use was significantly more frequent in women, in patients with CMUc (specific health coverage for low income patients) and decreased with age (p<0.0001, for all). SLE-specific comorbidities, including glomerular disease, skin involvement, polyarthritis, pleurisy, pericarditis, and thrombocytopenia, were significantly increased in patients with higher doses of OCS (p<0.0001, for all). Use of SLE treatments other than OCS was significantly increased in patients with higher doses of OCS (p<0.0001, for all) (Table 1). Strikingly, 14.6% of patients receiving 5 to 7.5 mg of OCS per day and 14.2% of those receiving more than 7.5 mg per day were not treated with antimalarial drugs, immunosuppressives or other biologic treatments for SLE. Complications of OCS, including cardiovascular diseases, infections, osteoporosis, and obesity, were significantly increased in SLE patients receiving ≥ 5 mg per day of OCS (p<0.0001 for all). The overall annual mean cost of healthcare consumptions from a societal perspective in 2019 was 6,048€ for prevalent SLE patients and 2,601€ for matched controls (p<0.0001). Among prevalent SLE patients, the cost increased significantly according to the OCS daily dose: 4,633€ for patients without OCS, 6,383€ (daily dose of 0-5 mg/day), 9,815€ (5-7.5 mg/day) and 13,861€ (above 7.5 mg/day).ConclusionTo the best of our knowledge, this is the first nation-wide study reporting on real-life use of OCS in patients with SLE. The proportion of patients treated with high-dose OCS ≥ 7.5mg/day remains unacceptably high and associated with increased comorbidities, OCS complications and significantly increased healthcare costs. Also, over 14% of patients receiving OCS doses ≥ 5 mg/day were not treated with antimalarial drugs, immunosuppressives or other biologic treatments for SLE. These results highlight the need for tight disease control and implementation of robust OCS-sparing strategies in SLE.Table 1.Proportion of patients treated with SLE treatments other than corticosteroids in 2019No OCSOCS0-5 mg/dayOCS5-7.5 mg/dayOCS≥ 7.5 mg/dayp-valueAntimalarials(Hydroxychloroquine/ Chloroquine)8,826 (53.0%)7,286 (63.5%)1,505 (72.9%)1,416 (71.9%)<0.0001Methotrexate958 (5.7%)1,405 (12.2%)361 (17.5%)358 (18.2%)<0.0001Mycophenolate mofetil337 (2.0%)878 (7.6%)350 (17.0%)496 (25.2%)<0.0001Azathioprine264 (1.6%)549 (4.8%)175 (8.5%)206 (10.5%)<0.0001Cyclophosphamide207 (1.2%)367 (3.2%)147 (7.1%)266 (13.5%)<0.0001REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsLaurent Arnaud Consultant of: Abbvie, Alexion, Alpine, Amgen, AstraZeneca, Biogen, BMS, Boehringer-Ingelheim, GSK, Grifols, Janssen, LFB, Lilly, Kezar, Medac, Novartis, Oséus, Pfizer, Roche-Chugaï, Sêmeia, UCB, Caroline Fabry-Vendrand Employee of: AstraZeneca, Remus Todea Employee of: AstraZeneca, Blandine VIDAL Employee of: AstraZeneca, Cottin Juliette Grant/research support from: I am employed by the company CEMKA who receive grants by pharmaceutical companies to conduct epidemiological and economic studies, Julien Robert Grant/research support from: I am employed by the company CEMKA who receive grants by pharmaceutical companies to conduct epidemiological and economic studies, Stéphane Bouée Grant/research support from: I am employed by the company CEMKA who receive grants by pharmaceutical companies to conduct epidemiological and economic studies, Gabriel Thabut Employee of: AstraZeneca.

Abstract Background: The prevalence of thalassemia in the US is rising due to migration, new births, and improved survival. Advances in monitoring and treatment have significantly reduced morbidity and mortality in transfusion-dependent thalassemia (TDT), the most severe form of this inherited disease. Thalassemia Treatment Centers (TTCs) utilize a comprehensive care model to provide expert-recommended and evidence-informed treatment, but a majority of the patients with TDT are not managed at such centers owing to long travel distance and lack of insurance portability. The resulting lack of access to specialized care increases the risk of complications and reduces health-related quality of life. To address this challenge, a national project was launched to develop Thalassemia Management Checklists (TMCs), a set of quick reference guides that provide decision support to physicians for blood transfusion, iron overload and chelation therapy. Methods: Three TTC's (New York, NY, Philadelphia, PA, and Oakland, CA) collaborated on the development of the following TMCs: (1) Guidelines for Managing Transfusion therapy for Thalassemia, (2) Monitoring of Iron Overload, and (3) Monitoring Deferasirox Therapy. A comprehensive review of literature including over 600 published studies and case reports, as well as the existing expert guidelines was conducted. Utilizing relevant references, the clinical guidelines were developed and a consensus on content and design of the Checklists was achieved. Subsequently, feedback obtained from national experts and patients with thalassemia was incorporated into the final Checklists. Results: Each Checklist was divided into three sections and formatted as a quick reference guide. Part 1 was a summary table having essential information printed on one side of letter-sized paper. For transfusion therapy, the table contained actions to be triggered by the pre-transfusion hemoglobin level. For iron overload, the optimal and elevated liver and cardiac iron concentration were defined along with the frequency of iron measurement using MRI. For monitoring of deferasirox, the monitoring guidelines for adverse effects and the response to abnormal laboratory tests were presented. Part 2 consisted of a literature review and rationale for the recommendations presented in the table, which was printed on the opposite face of the page. Part 3 was a bibliography of publications cited in the literature review that was made available online with a link provided in the TMC. The final product was three separate pages each covering a single topic, allowing easy access to the summary information while displaying detailed information on demand. The TMCs were distributed as printed copies to hematologists and can be downloaded from thalassemia-related websites. Discussion: The TTC's involved with this effort recognized that physicians providing care to only a few patients with TDT within general hematology (or more commonly oncology) -focused practices are far more likely to consult a desktop quick reference guide instead of a textbook, journal or handbook of comprehensive guidelines. TMCs are expected to cover most of the routine management of TDT while encouraging consultation with TTC's for complex decisions. TMCs will form the backbone of the first national attempt to standardize the management of TDT and reduce disparities in access to and quality of care. Over the next 3 years, the adoption of TMCs and their impact on patient care will be formally evaluated in selected regions. Patient access to TMCs through online publication will increase knowledge and promote self-advocacy. We are grateful to Craig Butler and Cooley's Anemia Foundation for coordinating this project. This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U1AMC28548: Cooperative Agreements to Support Comprehensive Medical Care for Thalassemia with no funds from non-governmental sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government. Disclosures Lal: Insight Magnetics: Research Funding; La Jolla Pharmaceutical Company: Consultancy, Research Funding; Novartis: Research Funding; Bluebird Bio: Research Funding; Terumo Corporation: Research Funding; Celgene Corporation: Research Funding. Sheth:Terumo Corporation: Research Funding; Novartis: Research Funding; La Jolla Pharmaceutical Company: Research Funding; Celgene Corporation: Consultancy, Research Funding; Bluebird Bio: Consultancy. Kwiatkowski:Novartis: Research Funding; Apopharma: Research Funding; bluebird bio: Consultancy, Honoraria, Research Funding; Terumo: Research Funding; Agios Pharmaceuticals: Consultancy, Research Funding.

BackgroundReal-world evidence (RWE) on prescription medication use for systemic lupus erythematosus (SLE) is limited, and no real-world studies to date have investigated medication use post-launch with anifrolumab, a type I interferon receptor inhibitor. ASTER is the first multi-national, real-world study to examine patients with SLE receiving standard therapy who initiate anifrolumab treatment as an add-on biologic.ObjectivesTo describe the study design of ASTER.MethodsASTER (NCT05637112) is a longitudinal, observational cohort study with 1 year of retrospective baseline data and 3 years of follow-up after first anifrolumab initiation until patient discontinuation, death, loss to follow-up or end of study (whichever occurs first). Adults with an SLE diagnosis per the 2019 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) criteria for SLE who start anifrolumab per the approved country-specific label are eligible. Patients who are anifrolumab experienced, currently in anifrolumab early access/compassionate use programs, or in a clinical trial with an investigational product are excluded. Eligible patients will be enrolled at a routine clinical visit before the first anifrolumab infusion. Key study measures and data collection methods are presented in the Table 1. Patient-reported outcomes (PROs) and diaries are selected and designed based on patient feedback. Key endpoints of disease activity and the proportion of patients attaining a Lupus Low Disease Activity State will be assessed. For patients who discontinue anifrolumab, data collection will continue for the entire follow-up period, unless they withdraw consent.ResultsAbout 500 patients are expected to be enrolled from Austria, Canada, Denmark, France, Germany, Israel, Italy, Norway, Spain, and Sweden, with 15–200 patients per country. The study will be open for enrollment in 2023 and data collection is expected to finish in 2029. Data will be collected at baseline and at quarterly (Year 1) or biannual visits (Years 2 and 3). Electronic case report forms will be used to record patient information using the Medidata RAVE system. MyReco®software will be used to record PROs via a mobile application and collect physician-completed assessments via a web platform. Results will primarily be descriptive.ConclusionASTER will provide physicians with valuable insights into the effectiveness of anifrolumab in patients with SLE in routine clinical practice. ASTER will generate comprehensive RWE of anifrolumab to inform patients about its impact on disease activity and health-related quality of life outcomes in global real-world settings.Table 1.Key study measuresDemographics(age, sex, ethnicity, insurance type)aClinical characteristics(comorbidities, medical history, adverse events/drug reactionsb, lab results)aSLE treatment history(steroids, antimalarials, immunosuppressants, NSAIDs, biologics)aSLE flaresaHealthcare resource useaClinical assessmentsc Physician’s Global Assessmentd SLE Disease Activity Index 2000d Cutaneous Lupus Erythematosus Disease Area and Severity Index Systemic Lupus International Collaborating Clinics/ACR Damage Indexa Low Lupus Disease Activity StatedPROsc Functional Assessment of Chronic Illness Therapy–Fatigue Lupus Quality of Life Patient Global Assessment European Quality of Life 5-Dimension Health Questionnaire 5 Level Work Productivity and Activity Impairment: Lupus Pain Numerical Rating Scale Diaries (e.g, medication use, pain, fatigue, sleep quality)eACR, American College of Rheumatology; NSAIDs, non-steroidal anti-inflammatory drugs;PRO, patient-reported outcome; SLE, systemic lupus erythematosus.aCollected at baseline and biannually in Years 1–3.bCollected throughout the study.cCollected at baseline, quarterly in Year 1, and biannually in Years 2–3.dPrimary objective.eCollected at baseline, weekly in Year 1 only.AcknowledgementsWriting assistance by Sheila Longo, PhD, of JK Associates Inc., part of Fishawack Health.This study was sponsored by AstraZeneca.Disclosure of InterestsMarta Mosca Speakers bureau: AstraZeneca, GSK, Janssen, Lilly, Consultant of: AstraZeneca, AbbVie, GSK, UCB, Lilly, Cathy Emmas Shareholder of: AstraZeneca, Employee of: AstraZeneca, Cassandra Nan Shareholder of: AstraZeneca, GSK, Employee of: AstraZeneca, Heide Stirnadel-Farrant Shareholder of: AstraZeneca, GSK, Employee of: AstraZeneca, Samuel Chen Shareholder of: AstraZeneca, Employee of: AstraZeneca, Lucy Carty Employee of: Currently employed by AstraZeneca as a contractor, Barnabas Desta Shareholder of: AstraZeneca, Employee of: AstraZeneca, Caroline Seo Shareholder of: AstraZeneca, Consultant of: HEOR consulting firm (Pharmerit-an OPEN Health Company), Employee of: AstraZeneca, Stephanie Chen Shareholder of: AstraZeneca, Employee of: AstraZeneca, Alessandro Sorrentino Shareholder of: Abbott Laboratories, Galapagos, Gilead, Kontigo Care, Moderna, Employee of: AstraZeneca; Before: Janssen and Sanofi.

Abstract Introduction Increasingly clinicians face the choice between CPX-351 (NCT01696084) and venetoclax and azacitadine (ven/aza, NCT02993523) in front-line acute myeloid leukemia (AML), especially for frailer older adults with comorbidities. Given no prospective data, we examined retrospective observational survival outcomes for patients with newly diagnosed AML receiving either CPX-351 or ven/aza as initial therapy. Methods After local Institutional Review Board approval, we included patients from both the University of Pennsylvania ("HUP", n=111) and the Flatiron Health electronic health record (EHR) derived, de-identified database with a first incident AML diagnosed between January 2017 and 2021, and with documented receipt of CPX-351 or venetoclax and azacitadine as initial therapy (n=548). Given a total of 219 patients received CPX-351 and 440 received ven/aza, there was 90% power to detect a hazard ratio (HR) of 0.77 or smaller with alpha 0.05. Overall Survival (OS) was analyzed by the Kaplan-Meier method and compared between arms using the log-rank test. Pre-planned sensitivity analyses included restriction and multiple imputation (MI) to address missingness with inverse-probability of treatment weighting (IPTW) to balance baseline covariates with treatment effect estimates from each imputed dataset combined via Rubin's rules. Results For all patients, baseline covariates showed patients receiving ven/aza were older (75 vs 65 years old median age), more likely to have Medicare (29% vs 20%), have de-novo AML vs secondary or therapy-related disease (52% vs 29%) and be treated in the community rather than an academic center (66% vs 52%). All other baseline covariates-including ELN cytogenetic risk groups, high risk mutations (TP53, ASXL1, RUNX1), FLT3, IDH, HCT-comorbidity index-were not statistically significant different between groups (table 1). Missing values in the HUP dataset was &lt;5% for all baseline covariates; Flatiron dataset missing values ranged from 0-56% for covariates (e.g., sex and baseline LDH respectively). Median OS (mOS) was 12 months for all patients and 13 months for CPX-351 versus 11 months for ven/aza (HR 0.87, 95% CI 0.70-1.07, p-value 0.184, Fig 1a). There was no clear subset with improved OS with CPX-351 vs ven/aza (Fig 1b); in multi-variate analysis controlling for all covariates with univariate p-value &lt; 0.20 induction choice did not affect overall survival (limited to complete cases n=133, HR 0.63, p-value 0.73). Restricting to only the population eligible for CPX-351 pivotal trial, there was no significant difference in OS (CPX-351 n=160 mOS=10, ven/aza n=181 mOS=12 HR 0.86 p-value 0.33). After MI and IPTW, survival remained similar with HR 0.95 p-value 0.77 (Fig 1c). Adjusting further for variables with absolute standardized difference &gt;10% after MI and IPTW (baseline HCT-comorbidity index, race and insurance status), multivariable Cox model gave similar results (HR 0.93, p-value 0.70). Regarding safety outcomes, early mortality was similar. However, documented diagnosed infections were higher in CPX-351 patients and within the HUP cohort, rates of febrile neutropenia and culture positive infection were also higher (Fig 1d). Length of stay, including any admission prior to next cycle of therapy, was more than twice as long for CPX-351 in the HUP cohort. Additional analyses, including detailed assessment of baseline covariates, multivariate analysis with transplant as a time-varying dependent covariate, event free survival, disease free survival also available for presentation. Conclusion In this multi-center real word dataset with over 600 patients, there was no statistically significant difference in overall survival between induction with CPX-351 and ven/aza. This large retrospective dataset is limited by missingness in covariates, risk of misclassification bias and lack of power for formal equivalence testing. However, a consistent lack of superiority for CPX-351 or ven/aza within a robust, manual chart-review of an academic institution, a large national real world database and combined analyses of these cohorts supports clinical equipoise. Given the apparent lack of a large survival benefit further work is needed. Prospective studies to confirm similar effectiveness with careful attention to side effects, quality of life and impact on transplant outcomes may help clinicians decide between these therapies. Figure 1 Figure 1. Disclosures Perl: Syndax: Consultancy; Loxo: Consultancy; Forma: Consultancy; AbbVie: Consultancy, Research Funding; Roche: Consultancy; Actinium: Consultancy; Genentech: Consultancy; Astellas: Consultancy, Research Funding; Daiichi Sankyo: Consultancy, Research Funding; Fujifilm: Research Funding; BMS/Celgene: Consultancy; Arog: Research Funding; Onconova: Consultancy; Sumitomo Dainippon: Consultancy. Luger: Syros: Honoraria; Agios: Honoraria; Daiichi Sankyo: Honoraria; Jazz Pharmaceuticals: Honoraria; Brystol Myers Squibb: Honoraria; Acceleron: Honoraria; Astellas: Honoraria; Pfizer: Honoraria; Onconova: Research Funding; Celgene: Research Funding; Biosight: Research Funding; Hoffman LaRoche: Research Funding; Kura: Research Funding. Frey: Kite Pharma: Consultancy; Novartis: Research Funding; Sana Biotechnology: Consultancy; Syndax Pharmaceuticals: Consultancy. Gill: Interius Biotherapeutics: Current holder of stock options in a privately-held company, Research Funding; Carisma Therapeutics: Current holder of stock options in a privately-held company, Research Funding; Novartis: Other: licensed intellectual property, Research Funding. Hexner: Blueprint medicines: Membership on an entity's Board of Directors or advisory committees, Research Funding; PharmaEssentia: Membership on an entity's Board of Directors or advisory committees; Tmunity Therapeutics: Research Funding. Porter: American Society for Transplantation and Cellular Therapy: Honoraria; ASH: Membership on an entity's Board of Directors or advisory committees; DeCart: Membership on an entity's Board of Directors or advisory committees; Genentech: Current Employment, Current equity holder in publicly-traded company; Incyte: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees; Kite/Gilead: Membership on an entity's Board of Directors or advisory committees; National Marrow Donor Program: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees, Patents & Royalties, Research Funding; Unity: Patents & Royalties; Wiley and Sons Publishing: Honoraria. Stadtmauer: Oncopeptides: Consultancy; Amgen: Consultancy; BMS Celgene: Consultancy; GSK: Consultancy; Janssen: Consultancy; AbbVie: Consultancy, Research Funding. Maillard: Regeneron: Research Funding. Margolis: Pfizer: Consultancy; Leo: Consultancy; Sanofi: Consultancy; National Eczema Association: Membership on an entity's Board of Directors or advisory committees. Pratz: Abbvie: Consultancy, Honoraria, Research Funding; Agios: Consultancy; BMS: Consultancy, Honoraria; Novartis: Consultancy; Astellas: Consultancy, Honoraria, Research Funding; Cellgene: Consultancy, Honoraria; Millenium: Research Funding; University of Pennsylvania: Current Employment.

Abstract Background: The National Comprehensive Cancer Network guideline on Genetic/Familial High Risk: Breast, Ovarian and Pancreatic Cancer (NCCN) recommends offering increased screening and risk-reduction options to women with a pathogenic/likely pathogenic variant (PV/LPV) in 8 clinically-actionable hereditary breast and ovarian cancer (HBOC) genes: ATM, BRCA1, BRCA2, CDH1, CHEK2, PALB2, PTEN, and TP53. These options range from biannual clinical breast exams and annual breast MRI screening to risk-reducing mastectomy (RRM) and salpingo-oophorectomy (RRSO). Yet health insurance company policies addressing the medical necessity of genetic testing for these genes vary widely. While some payers have adopted the NCCN testing criteria verbatim, others have made specific changes or have developed their own criteria. We sought to quantify the potential impact of this variability on access to enhanced medical management for carriers of PV/LPV in these 8 HBOC genes in a large cohort of patients undergoing genetic testing at a single commercial laboratory. Methods: We reviewed clinical and family histories for patients undergoing multigene panel testing that included testing for the 8 genes of interest and identified 107,344 patients who met NCCN testing criteria (excluding prostate cancer criteria, which were not assessed in this study) for HBOC (v.2.2021). We then compared the histories of these patients to testing criteria for 3 different payer groups: Aetna, Blue Shield of California/Federal Blue Cross-Blue Shield, and eviCore (used by over 30 payers including AmeriHealth, Highmark and Horizon). These are the largest payer groups in our cohort and together represent 19% of patients tested. For each patient we determined whether they met testing criteria for the 3 payer groups. For individuals found to have a PV/LPV we determined the potential missed management opportunities for those who would not have been tested under each payer’s criteria. In addition, we sought to estimate the maximal impact of this missed management for patients with BRCA PV/LPV (not accounting for patient age or medical history). Results: Among patients meeting NCCN testing criteria for HBOC, 10,10,477 (9.8%) were found to have PVs/LPVs in one of the 8 genes. Under the three payer policies 2% to 10.3% of all patients, and up to 4.0% (n=423) of PV/LPV carriers, would not have been eligible for genetic testing. Based on NCCN management guidelines, up to 423 eligible patients would not have been offered annual breast MRI, 208 patients would not have been offered RRM, and 163 eligible patients would not have been offered RRSO. This lack of testing access due to misaligned medical policies also represents missed opportunities for offering potentially life-saving screening and risk reduction measures to these patients as well. Assuming lifetime cancer risks of 85% for breast cancer and 40% for ovarian cancer, and risk-reduction of 95% with RRM and 80% with RRSO. Had all policies matched NCCN testing criteria, up to 132 breast cancers could have potentially been detected earlier or prevented and 52 ovarian cancers could potentially have been prevented in our cohort. Conclusions: In addition to complicating clinical practice, varying testing guidelines have broader implications. Our data show that a significant number of mutation carriers are being missed by payer policies that deviate from NCCN testing criteria. In turn, this represents missed opportunities to offer proactive screening and risk-reduction options that could potentially save lives for those at risk for hereditary cancer. Based on findings from other studies, these actions would likely reduce health insurer costs as well. Citation Format: Robert T Pilarski, Stephanie Noble, Lily Hoang, Randy Hew, Stephanie Gandomi, Holly LaDuca, Jill Dolinsky. Inequitable access to genetic testing leads to missed screening and prevention opportunities for individuals at risk for hereditary breast and ovarian cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-09-19.

Abstract Opioid analgesics are used to treat cancer-related pain and improve quality of life, however overuse of these high-risk drugs has been associated with significant public health implications as exhibited by the national attention received during the opioid pandemic. In addition, pain associated with hematologic malignancies is frequent yet not well understood. There is no data examining opioid use and outcomes in patients with hematologic malignancies and recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Therefore, we sought to describe chronic opioid use (COU) and its impact on long-term outcomes in patients undergoing allo-HSCT. We analyzed outcomes of adult patients ≥ 18 years (n=159) diagnosed with hematologic malignancies (n=151) or benign hematologic disorders (n=8) (excluding sickle cell disease) who received allo-HSCT between 2012 and 2019 at a single urban medical center. COU was defined as having a documented active prescription for 3 consecutive months. Daily opioid doses were converted to morphine milligram milliequivalents (MME) using standard conversion factors. Among the entire cohort, the median age was 55.4 (19.4-74.3) years, 94 (59.1%) were male, 70 (44%) were White, 42 (26.4%) were Hispanic, and 26 (16.4%) were Black. The majority of patients were diagnosed with acute leukemia, with 89 (56%) having AML and 16 (10%) having ALL patients. Of the remaining patients, 14 (8.8%) were CML-BP or CML-AP, 16 (10%) NHL/HD, and 15 (9.4%) MPDs. 33.5% of patients were found to have high or very high DRI prior to allo-HSCT. Most patients received either a myeloablative (n=102, 64.2%) or reduced-intensity (n=55, 34.6%) conditioning regimen. At baseline (immediately prior to allo-SCT), COU was observed in 38 (23.9%) patients, 20 (52.6%) of which were diagnosed with AML. Only 23 (60.5%) patients with COU had a documented indication for opioid analgesia. The baseline median MME per day was 23.5mg (range: 2-150). In logistic regression analysis including demographic and social factors such as insurance type (i.e. Medicare, Medicaid, private payer), education level, smoking, alcohol, illicit drug and/or benzodiazepine use, and employment status, only older age (RR 0.97, 95% CI 0.94-0.99; p=0.026) was associated with a lower likelihood of baseline COU. In total, 149 (93.7%) patients received opioids during the allo-HSCT admission, while 45 (28.3%) were discharged on opioids. The reason for being discharged on opioids was related to musculoskeletal pain (n=19), residual mucositis-related pain (n=7), and headache (n=3). This was found to persist over time, with 35 (92.1%) of the 45 patients discharged on opioids remaining on opioids at 180 days after allo-HSCT thus meeting the definition for COU. The only factor found to predict for COU at 6 months was discharge from initial transplant hospitalization with an opioid (RR 2.24, 95% CI 1.16-4.32, p=0.016). Not only did a significant number of post-transplant survivors meet the definition for COU, but the MME was found to be relatively high with a median of 50mg (range: 10-540) at discharge and 30mg (range: 4.5-202) on days +30, 90, 180 as well as at 1 and 5 years after allo-HSCT. In a multivariable modified Poisson regression with robust standard errors for binary outcomes, when adjusted for established prognostic characteristics (i.e., disease, DRI, HCT-CI), we found that COU prior to admission strongly predicted for worse overall survival (HR 2.99, 95% CI 1.59-5.64; p=0.001), progression free survival (HR 2.72, 95% CI 1.48-4.99), and GVHD free, relapse-free survival (HR 1.78, 95% CI 1.05-3.03; p=0.033). This study is the first to describe patterns of COU, an important public health problem, among patients undergoing allo-HSCT, and in particular in long term survivors. We demonstrate high rates of baseline COU in patients undergoing allo-HSCT as well as persistent long term COU, which is linked to prescribing patterns after the initial transplant hospitalization. In addition, we show the negative impact of baseline COU on overall survival, even when adjusted for disease- and transplant-related factors. These data highlight the need to improve understanding and management of pain in hematologic malignancies as well as to reinforce the need for continuous reassessment of the use of opioids prior to and after allo-HSCT. Disclosures Calip: Flatiron Health: Current Employment; Roche: Current equity holder in publicly-traded company; Pfizer: Research Funding. Rondelli: Vertex: Membership on an entity's Board of Directors or advisory committees. Patel: Celgene: Consultancy.

A review article devoted to the book of Andrzej Blikle – Doktryna jakości. Rzecz o skutecznym zarządzaniu. As pointed out by the Author, the book is a case of a work rare on the Polish publishing market, written by an outstanding scientist, who successfully runs a business activity. The combination of practical experience with theoretical knowledge gave a result that may be satisfying both for practitioners as well as theorists, and also those who want to get to know the ins and outs of an effective and efficient business management. The Author of the review believes that it is an important voice for shaping an inclusive socio-economic system, which constitutes a value in itself. Although the book is mainly concerned with business management, its message has a much wider dimension and is concerned with real measures of wealth, money and people’s lives. The book was awarded The SGH Collegium of Business Administration Award “For the best scientific work in the field of business administration in the years 2014-2015”. Andrzej Jacek Blikle Doktryna jakości. Rzecz o skutecznym zarządzaniu (The Doctrine of Quality. On Effective Management) Gliwice, Helion Publishing Company, 2014, p. 546 Introduction One of the distinctive features of the contemporary economy and contemporary world is a kind of obsession of quantity which is related to thoughtless consumerism, unfavourable to the care for the quality of the work and the quality of the produced and consumed goods and services. It is accompanied by culture (or rather non-culture) of singleness. Therefore, the book The Doctrine of Quality by Andrzej Blikle is like a breath of fresh air. It is a different perspective on the economy and the model of operation of enterprises, on the model of work and life of people. A. Blikle proves that it can be done otherwise. He proves it on the basis of careful studies of the source literature – as expected from a professor of mathematics and an economist, but also on the basis of his own experience gained during the scientific and educational work, and most of all through the economic practice. In the world governed by the obsession of quantity, characterised by fragility, shortness of human relationships, including the relationship of the entrepreneur – employee, A. Blikle chooses durability of these relations, creativity, responsibility, quality of work and production, and ethics. The Doctrine of Quality is a rare example of the work on the Polish publishing market, whose author is a prominent scientist, successfully conducting a business activity for more than two decades, which has contributed to the development of the family company – a known confectionery brand “A. Blikle”. The combination of practical experience with theoretical knowledge gave a result that may be satisfying both for practitioners as well as theorists, and also those who want to get to know the ins and outs of an effective and efficient business management, or develop the knowledge on this topic. In an attractive, clear narrative form, the author comprehensively presents the complexities of business management, indicating the sources of success, but also the reasons and the foundations of failures. At the same time, he presents these issues with an interdisciplinary approach, which contributes to thoroughness of the arguments and deeper reflections. Holism, typical to this book, is also expressed in the focus of A. Blikle not only on the economic, but also on social and ecological issues. Here, the author points to the possibility and need of reconciliation of the economic interests with social interests, and the care for the public good. Analyses of this subject are presented using the achievements of many areas of studies, in addition to economic sciences, including mathematics, sociology, psychology, medicine, and others. This gives a comprehensive picture of the complexity of business management – taking into account its close and distant environment. There are no longueurs in the book, although extensive (over 500 pages), or lengthy, or even unnecessary reasoning overwhelming the reader, as the text is illustrated with a number of examples from practice, and coloured with anecdotes. At the same time, the author does not avoid using expressions popular in the world of (not only) business. He proves that a motivational system which is not based on the approach of “carrot and stick” and without a devastating competition of a “rat race” is possible. The author supports his arguments with references not only to the interdisciplinary scientific achievements, but also to the economic historical experiences and to a variety of older and newer business models. There is a clear fascination with the reserves of creativity and productivity in the humanization of work. In fact, the author strongly exposes the potential of productivity and creativity in creating the conditions and atmosphere of work fostering elimination of fear of the future. He shows that such fear destroys creativity. It is not a coincidence that A. Blikle refers to the Fordist principles, including the warning that manufacturing and business do not consist of cheap buying and expensive selling. He reminds that Henry Ford, a legendary creator of the development of the automotive industry in the United States, put serving the public before the profit. The Doctrine of Quality is at the same time a book – proof that one of the most dangerous misconceptions or errors in the contemporary understanding of economics is finding that it is a science of making money, chremastics. Edmund Phelps and others warned against this in the year of the outbreak of the financial crisis in the USA in 2008, reminding that economics is not a science of making money but a science of relations between the economy and social life [Phelps, 2008]. Economics is a science of people in the process of management. Therefore, by definition, it applies to social values and ethos. Ethos is a general set of values, standards and models of proceedings adopted by a particular group of people. In this sense, ethos and economics as a science of people in the process of management are inseparable. Detaching economics from morality is in contradiction to the classical Smithian concept of economics, as Adam Smith combined the idea of the free market with morality. He treated his first work, The Theory of Moral Sentiments, as an inseparable basis for deliberations on the nature and causes of the wealth of nations, which was the subject of the subsequent work of this thinker [Smith, 1989; Smith, 2012]. Identifying economics with chremastics would then mean that all actions are acceptable and desired, if their outcome is earnings, profit, money. The book of A. Blikle denies it. It contains a number of case studies, which also stimulate broader reflections. Therefore, and also due to the features indicated above, it can be a very useful teaching aid in teaching entrepreneurship and management. The appearance of a book promoting the doctrine of quality and exposing the meaning of ethos of work is especially important because today the phenomenon of product adulteration becomes increasingly widespread, which is ironically referred to in literature as the “gold-plating” of products [Sennett, 2010, pp. 115-118], and the trend as “antifeatures”, that is intentionally limiting the efficiency and durability of products of daily use to create demand for new products. A model example of antifeature is a sim-lock installed in some telephones which makes it impossible to use SIM cards of foreign operators [Rohwetter, 2011, p. 48; Miszewski, 2013]. These types of negative phenomena are also promoted by the development of systemic solutions aiming at the diffusion of responsibility [Sennett, 2010]. This issue is presented among others by Nassim N.N. Taleb, in the book with a meaningful title Antifragile: How to Live in a World We Don’t Understand? The author proves that the economy and society lose their natural durability as a result of the introduction of numerous tools and methods of insurance against risks, but mostly by shifting the burden of risks on other entities [Taleb, 2012]. N.N. Taleb illustrates his arguments with numerous convincing examples and references to history, recalling, inter alia, that in ancient times there was no building control, but the constructors, e.g. of bridges had to sleep under them for some time after their construction, and the ancient aqueducts are still working well until today. So, he shows that a contemporary world, focused on quantitative effects, does not create a sound base for ethical behaviours and the care for the quality of work and manufacturing. Andrzej Blikle points to the need and possibility of opposing this, and opposing to what the Noble Price Winner for Economics, Joseph Stiglitz described as avarice triumphs over prudence [Stiglitz, 2015, p. 277]. The phrase emphasised in the book “Live and work with a purpose” is the opposition to the dangerous phenomena listed above, such as for example antifeatures. convincing that although the business activity is essentially focused on profits, making money, limited to this, it would be led to the syndrome of King Midas, who wanted to turn everything he touched into gold, but he soon realised that he was at risk of dying of starvation, as even the food turned into gold. What distinguishes this book is that almost every part of it forces in-depth reflections on the social and economic relations and brings to mind the works of other authors, but at the same time, creates a new context for them. So, A. Blikle clearly proves that both the economy and businesses need social rooting. This corresponds to the theses of the Hungarian intellectual Karl Polanyi, who in his renowned work The Great Transformation, already in 1944 argued that the economy is not rooted in the social relations [Polanyi, 2010, p. 70]. He pointed to the risk resulting from commodification of everything, and warned that allowing the market mechanism and competition to control the human life and environment would result in disintegration of society. Although K. Polanyi’s warnings were concerned with the industrial civilization, they are still valid, even now – when the digital revolution brings fundamental changes, among others, on the labour market – they strengthen it. The dynamics of these changes is so high that it seems that the thesis of Jeremy Rifkin on the end of work [Rifkin, 2003] becomes more plausible. It is also confirmed by recent analyses included in the book of this author, concerning the society of zero marginal cost and sharing economy [Rifkin, 2016], and the analyses concerning uberisation [Uberworld, 2016]. The book of Andrzej Blikle also evokes one of the basic asymmetries of the contemporary world, which is the inadequacy of the dynamics and sizes of the supply of products and services to the dynamics and sizes of the demand for them. Insufficient demand collides with the rapidly increasing, as a result of technological changes, possibilities of growth of production and services. This leads to overproduction and related therewith large negative implications, with features of wasteful economy of excess [Kornai, 2014]. It is accompanied by phenomena with features of some kind of market bulimia, sick consumerism, detrimental both to people and the environment [Rist, 2015]. One of the more compromising signs of the economy of excess and wasting of resources is wasting of food by rich countries, when simultaneously, there are areas of hunger in some parts of the world [Stuart, 2009]. At the same time, the economy of excess does not translate to the comfort of the buyers of goods – as in theory attributed to the consumer market. It is indicated in the publication of Janos Kornai concerning a comparative analysis of the features of socio-economic systems. While exposing his deep critical evaluation of socialist non-market systems, as economies of constant deficiency, he does not spare critical opinions on the capitalist economy of excess, with its quest for the growth of the gross domestic product (GDP) and profits. As an example of the economy of excess, he indicates the pharmaceutical industry, with strong monopolistic competition, dynamic innovativeness, wide selection for the buyers, flood of advertisements, manipulation of customers, and often bribing the doctors prescribing products [Kornai 2014, p. 202]. This type of abnormalities is not alien to other industries. Although J. Konrai appreciates that in the economy of excess, including the excess of production capacities, the excess is “grease” calming down and soothing clashes that occur in the mechanisms of adaptation, he also sees that those who claim that in the economy of excess (or more generally in the market economy), sovereignty of consumers dominates, exaggerate [Kornai, 2014, pp. 171-172], as the manufacturers, creating the supply, manipulate the consumers. Thus, there is an excess of supply – both of values as well as junk [Kornai, 2014, p. 176]. Analysing the economy of excess, J. Kornai brings this issue to the question of domination and subordination. It corresponds with the opinion of Jerzy Wilkin, according to whom, the free market can also enslave, so take away individual freedom; on the other hand, the lack of the free market can lead to enslavement as well. Economists willingly talk about the free market, and less about the free man [Wilkin, 2014, p. 4]. The economy of excess is one of the consequences of making a fetish of the economic growth and its measure, which is the gross domestic product (GDP) and treating it as the basis of social and economic activity. In such a system, the pressure of growth is created, so you must grow to avoid death! The system is thus comparable to a cyclist, who has to move forwards to keep his balance [Rist, 2015, p. 181]. It corresponds with the known, unflattering to economists, saying of Kenneth E. Boulding [1956], criticising the focus of economics on the economic growth, while ignoring social implications and consequences to the environment: Anyone who believes in indefinite growth in anything physical, on a physically finite planet, is either mad or an economist. [from: Rist, 2015, p. 268]. GDP is a very much needed or even indispensable measure for evaluation of the material level of the economies of individual countries and for comparing their economic health. However, it is insufficient for evaluation of the real level of welfare and quality of life. It requires supplementation with other measures, as it takes into account only the values created by the market purchase and sale transactions. It reflects only the market results of the activity of enterprises and households. Additionally, the GDP account threats the socially desirable and not desirable activities equally. Thus, the market activity related to social pathologies (e.g. functioning of prisons, prostitution, and drug dealing) also increase the GDP. It was accurately expressed already in 1968 by Robert Kennedy, who concluded the discussion on this issue saying that: the gross national product does not allow for the health of our children, the quality of their education or the joy of their play. It does not include the beauty of our poetry or the strength of our marriages, the intelligence of our public debate or the integrity of our public officials. It measures neither our wit nor our courage, neither our wisdom nor our learning, neither our compassion nor our devotion to our country, it measures everything in short, except that which makes life worthwhile [The Guardian, 2012]. While Grzegorz W. Kołodko even states that it should be surprising how it is possible that despite a number of alternative measures of social and economic progress, we are still in the corset of narrow measure of the gross product, which completely omits many significant aspects of the social process of reproduction [Kołodko, 2013, p. 44]. In this context he points to the necessity of triple sustainable growth – economic, social, and ecological [Kołodko, 2013, p. 377]. Transition from the industrial civilisation model to the new model of economy, to the age of information, causes a kind of cultural regression, a phenomenon of cultural anchoring in the old system. This type of lock-in effect - described in the source literature, that is the effect of locking in the existing frames and systemic solutions, is a barrier to development. The practice more and more often and clearer demonstrates that in the conditions of the new economy, the tools and traditional solutions turn out to be not only ineffective, but they even increase the risk of wrong social and economic decisions, made at different institutional levels. All this proves that new development models must be searched for and implemented, to allow counteraction to dysfunctions of the contemporary economy and wasting the development potential, resulting from a variety of maladjustments generated by the crisis of civilisation. Polish authors who devote much of their work to these issues include G.W. Kołodko, Jerzy Kleer, or Maciej Bałtowski. Studies confirm that there is a need for a new pragmatism, new, proinclusive model of shaping the social and economic reality, a model which is more socially rooted, aiming at reconciling social, economic and ecological objectives, with simultaneous optimisation of the use of the social and economic potential [Kołodko, 2013; Bałtowski, 2016; Kleer, 2015]. There is more and more evidence that the barriers to economic development growing in the global economy are closely related with the rooting of the economy in social relations. The book of A. Blikle becomes a part of this trend in a new and original manner. Although the author concentrates on the analyses of social relations mainly at the level of an enterprise, at the same time, he comments them at a macroeconomic, sociological and ethical level, and interdisciplinary contexts constitute an original value of the book. Conclusion I treat the book of Andrzej Blike as an important voice in favour of shaping an inclusive social and economic system, in favour of shaping inclusive enterprises, that is oriented on an optimal absorption of knowledge, innovation and effective reconciliation of the interests of entrepreneurs with the interests of employees and the interests of society. Inclusiveness is indeed a value in itself. It is understood as a mechanism/system limiting wasting of material resources and human capital, and counteracting environmental degradation. An inclusive social and economic system is a system oriented on optimisation of the production resources and reducing the span between the actual and potential level of economic growth and social development [Reforma, 2015]. And this is the system addressed by Andrzej Blikle in his book. At least this is how I see it. Although the book is mainly concerned with business management, its message has a much wider dimension and is concerned with real measures of wealth, money and people’s lives. null

Insurance is a type of financial product that provides a financial safety net against loss or damage in exchange for regular payments known as premiums. In insurance, a person or entity is insured and another party, the insurer, provides coverage for specified losses or damages. A well-developed insurance sector contributes for the growth of any country to a greater extent. The efficiency of insurance sector can be measured by studying its financial performance. The present study focuses on comparing the financial performance of select non-life insurance companies during the period 2010-11 to 2021-22. Two public sector companies- The New India Assurance Company Ltd and National Insurance Company Ltd and two private sector insurers- ICICI Lombard and Bajaj Allianz are considered for the study. The company’s financial position is studied using CARAMEL Analysis. It was concluded that The New India Assurance Company Ltd leaded the select companies under study. Key Words: Insurance, ratios, CARAMEL, financial performance, public sector, private sector, insurers

Sharia Insurance according to a binding ruling in religious matters (fatwa) of the National Shari'ah Board of the Indonesian Ulama Council no: 21 /DSN-MUI/ X / 2001 is a mutual effort to help among a number of people/parties through investment in assets or tabarru' which provides a pattern of return to face certain risks through engagement in accordance with the sharia. PRUlink sharia is an insurance product associated with sharia-based investment. PRUlink Syariah is designed to meet the society's need for future financial designs in accordance with Islamic principles of sharia. There are two types of product of PRUlink Syariah insurance, namely PRUlink Syariah Investor Account and PRUlink Syariah Assurance Account. Kind of Product in PRUlink Syariah is contract between policy holders using contract of tabarru which is called hibah and the owner of the policy/participant premises sharia insurance company using contract of tijarah called wakalah bin ujrah. In sharia insurance there is a surplus sharing that will be distributed to customers calculated at the end of the calendar year. This can be obtained if there are more funds than tabarru' accounts that have been reduced by claims and debt to the company if any. How is PRUlinksyariah managed in Prudential? The result of the research shows that PRUsyariah premium management in Prudential is separated by two accounts, namely tabarru' account and investment account. The own fund is managed by Eastpring Investment, that is manager company from Asia prudential, while allocation of fund is invested in stocks and obligation which is in accordance with sharia principles contained in the Jakarta Stock Exchange. For the choice of investment in PRUsariah, there are three options of investment, namely Sharia-Rupiah Equity Fund, Sharia-Rupiah Managed Fund or Sharia-Rupiah fixed Income fund, in accordance with the choice of the next participant. From the investment result the participant agrees to pay tabarru’ contribution directly input into tabarru' account. Tabarru’ funds are fully owned by participants and used to pay claims participants claim at any time, but if there is tabaaru’ funds excess with claims total in one year as of 31 December paid, then tabarru’ surplus or that is called surplus will be distributed participants that meet the requirements to get the surplus. Keywords: Tabarru’ Fund Management, Sharia Insurance, Prudential Life

The economic sense of insurance marker at the article is determined. The insurance market is relations of insurance service realization and possibility of insurance funds to create conditions of risk reduction and elimination for all participation of economics activities and all segments of the population. Problems of insurance companies’ activities were determined at many scientific sources. Activities of life insurance companies at Ukrainian market were determine. Analyze of insurance companies’ data on national market was made, the main problems and measure of creation situation on insurance market of Ukraine. The insurance brokers, their classification and their functions were determined. But at modern research there are not analyze of insurance companies’ activities on global insurance market. The main aim of article is analyzed of insurance companies’ activities on global insurance market, the global tendencies on global insurance market was determined. Also, this article is dedicated to analyze of insurance companies on wolds insurance services market. At the article the important data such as the ratio of real estate premiums to victims and the ratio of life premiums to annuities. As basic for analyze great insurance companies of German, Great Britain USA, France, Switzerland, Bermuda. Also were analyzed data of most great world insurance brokers. Also the data of activity of world property insurance and life insurance companies were analyzed. Was determined, that during 2019 and 2020 profit of world insurance brokers create. Also was determined, that during 2019 life insurance profit of world insurance companies was created. The traditional insurance is not more the main business of life insurance field. The influence of pandemic COVID 19, showed both positives and negatives effects. Pandemic show impotent of having protection against force mayor. That is why, the support increased as for customer and for companies. Very impotent for insurance company to offer digital communication of all aspects, because it is world tendency. It is very important to develop these tendencies all time.